During an 8-year period, 104 patients (19 males, 85 females) underwent surgery for a solitary thyroid nodule. There were 19 (18.3%) malignant nodules and 85 (81.7%) benign nodules. Malignancy occurred in 3 (15.8%) males and 16 (18.8%) females. Pre-operative scanning was performed prior to referral in 59 patients (52 had ultrasound, 41 had isotope scanning; the majority had both). Of the scanned patients, 12 (20%) had a malignant nodule while 7 (15.5%) of the 45 patients who did not have scanning had a malignant nodule. In patients who had an ultrasound scan, malignancy was found in 5 (23.8%) of the 21 solid nodules and 7 (22.7%) of the 31 cystic (or solid/cystic) nodules. In patients who had thyroid isotope scanning, malignancy was found in 6 (17.5%) of the 34 cold (non-functioning) nodules and 3 (43%) of the 7 warm or hot (functioning) nodules. Ultrasound and isotope scanning may be misleading and neither help to differentiate benign from malignant thyroid nodules which require surgical excision.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Ashcraft, M. W., Van Herle, A. J. Management of thyroid nodules I: history and physical examination, blood tests, x-ray tests and ultrasonography. Head Neck Surg. 1981; 3: 216–30.
Crile, G. Treatment of thyroid cysts by aspiration. Surgery 1966; 59: 210–12.
Rosen, I. B., Walfish, P. G., Muskin, M. The application of ultrasound to the study of thyroid enlargement: Management of 450 cases. Arch Surg. 1975; 110: 940–4.
Ashcraft, M. W., Van Herle, A. J. Management of thyroid nodules II: scanning techniques, thyroid suppressive therapy and fine needle aspiration. Head Neck Surg. 1981; 3: 297–322.
Shulkin, B. L., Shapiro, B. The role of imaging tests in the diagnosis of thyroid carcinoma. Clin. Endocrinol. Metab. North Am. 1990; 19: 53–63.
Rojeski, M. T., Gharib, H. Nodular thyroid disease. N. Engl. J. Med 1985; 313: 428–36.
Anderson, J. B., Webb, A. J. Fine-needle aspiration biopsy and the diagnosis of thyroid cancer. Br. J. Surg. 1987; 74: 292–6.
Cusick, E. L., Mclntosh, C. A., Kruwowski, Z. H., Matheson, N. A. Cystic change and neoplasia in isolated thyroid swellings. Br. J. Surg. 1988; 75: 982–3.
Evans, D. M. Diagnostic discriminants of thyroid cancer. Am. J. Surg. 1987; 153: 569–70.
Hammer, M., Wortsman, J., Folse, R. Cancer in cystic lesions of the thyroid. Arch. Surg. 1982; 117: 1020–3.
Block, M. A. Surgery of thyroid nodules and malignancy. Curr. Probl. Surg. 1983; 20: 133–203.
Rosen, I. B., Wallace, C., Strawbridge, H. G., Walfish, P. G. Re-evaluation of needle aspiration cytology in detection of thyroid cancer. Surgery 1981; 90: 947–55.
Cox, M. R., Marshall, S. G., Spence, R. A. J. Solitary thyroid nodule: a prospective evaluation of nuclear scanning and ultrasonography. Br. J. Surg. 1991; 78: 90–3.
Gharibh, H., Goellner, J. R. Evaluation of nodular thyroid disease. Clin. Endocrin. Metab. North Am. 1988; 17: 511–26.
Brooks, J. R., Starnes, H. F., Brooks, D. C., Pelkey, J. N. Surgical therapy for thyroid carcinoma: a review of 1249 solitary thyroid nodules. Surgery 1988; 104: 940–5.
Psarras, A., Papadopoulus, S. N., Livadas, D., Pharmakiotos, A. D., Koutas, D. A. The single thyroid nodule. Br. J. Surg. 1967; 59: 545.
Hoffman, G. L., Thompson, N. W., Heffron, C. The solitary thyroid nodule. A reassessment. Arch. Surg. 1972; 105: 379–85.
Gharibh, H., Goellner, J. R., Zinsmeister, A. R., Grant, C. S., Van Heerden, J. A. Fine needle aspiration biopsy of the thyroid. The problem of suspicious cytologic findings. Ann. Intern. Med. 1984; 101: 25–28.
Saxe, A. W. Thyroid scans and the diagnosis of carcinoma of the thyroid. Surg. Gyn. Obs. 1979; 149: 729–30.
Harsoulis, P., Leontsini, M., Economou, A., Gerasimidas, T., Smbarounis, C. Fine needle aspiration biopsy cytology in the diagnosis of thyroid cancer: comparative study of 213 operated patients. Br. J. Surg. 1986; 73: 461–4.
Esselstyn, C. B., Crile, G. Evaluation of various types of needle biopsies of the thyroid. World J. Surg. 1984; 8: 452–7.
Esselstyn, C. B., Crile, G. Needle aspiration and needle biopsy of the thyroid. World J. Surg. 1978; 2: 321–9.
Lowenhagen, T., Granberg, P. O., Lundell, G. Aspiration biopsy cytology (ABC) in tumours of the thyroid gland suspected to be malignant. Surg. Clin. North Am. 1979; 59: 3.
Lowenhagen, T., Willems, J.-S., Lundell, G., Sundblad, R., Granbert, P. Aspiration biopsy cytology in diagnosis of thyroid cancer. World J. Surg. 1981; 5: 61–73.
Lennquist, S. The thyroid nodule. Diagnosis and treatment. Surg. Clin. North Am. 1987; 67: 213–32.
Nishiyama, R. H., Bigos, S. T., Goldfarb, W. B., Flynn, S. D., Taxiarchis, L. N. The efficacy of simultaneous fineneedle aspiration and large-needle biopsy of the thyroid gland. Surgery 1986; 100: 1133–7.
Kaplan, M. M. Progress in thyroid cancer. Clin. Endocrin. Metab. North Am. 1990: 19: 469–77.
Hamburger, J. I., Husain, M. Contribution of intraoperative pathology evulation to surgical management of thyroid nodules. Clin. Endocrin. Metab. North Am. 1990; 19: 509–21.
McCall, A., Jarosz, H., Lawrence, A. M., Paloyan, E. The incidence of thyroid carcinoma in solitary cold nodules and in multinodular goitres. Surgery 1986; 100: 1128–31.
Shaw, J. H. F., Dodds, S. P. Carcinoma of the thyroid gland in Auckland, New Zealand. Surg. Gyn. Obs. 1990; 171: 27–32.
Lahey, F. H., Hare, H. F. Malignancy in adenomas of the thyroid. JAMA 1951; 145: 689–95.
Pigott, J. D., Braund, R. R. The thyroid nodule and thyroid cancer. Southern Med. J. 1963; 56: 534.
About this article
Cite this article
Kneafsey, B., Gillen, P. & Brady, M.P. Limitations of thyroid scanning in solitary thyroid nodules. I.J.M.S. 163, 451–454 (1994). https://doi.org/10.1007/BF02940564
- Thyroid Cancer
- Thyroid Carcinoma
- Thyroid Nodule
- Fine Needle Aspiration Cytology
- Follicular Carcinoma