Xi-Yue Yang , Li-Fang Huang , Yue-Jian Han , Xiao-Xin Cen
{"title":"Malignant risk of thyroid nodules with isolated macrocalcifications – A study based on surgery results","authors":"Xi-Yue Yang , Li-Fang Huang , Yue-Jian Han , Xiao-Xin Cen","doi":"10.1016/j.clinsp.2025.100657","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>To determine the malignancy risk of thyroid nodules with Isolated Macrocalcifications (IMC) based on surgical results and evaluate the postoperative risk of malignant nodules with IMC.</div></div><div><h3>Methods</h3><div>A total of 46 thyroid nodules with IMC were enrolled from 3680 consecutive patients who underwent thyroidectomy between August 2018 and September 2023. The malignancy risk of IMC nodules, postoperative risk of malignant nodules, and whether the ultrasonic features of IMC (smooth, lobulated, or focal disruption of the anterior margin) were associated with malignancy were investigated. The nodules were further divided into three groups (group A, maximum diameter < 10 mm; group B, maximum diameter of 10‒14 mm and group C, maximum diameter ≥ 15 mm). Differences in malignancy and Lymph Node Metastasis (LNM) risks were also evaluated among the three groups.</div></div><div><h3>Results</h3><div>The malignancy risk of the IMC nodules was 30.43% (14/46). Four patients developed LNM. Eight nodules were staged as T1aN0M0 and low-risk, whereas six nodules were staged as T1bN1aM0 and intermediate-risk. Focal disruption of the anterior margin of IMC was significantly associated with malignancy. Malignant and LNM risk showed no differences among nodules with different sizes.</div></div><div><h3>Conclusions</h3><div>IMC nodules with different sizes had a lower intermediate risk of malignancy and exhibited the same aggressive behavior. The cutoff value of these nodules for further Fine Needle Aspiration (FNA) warranted further investigation. Interruption of IMC was more often seen in malignant nodules, and more attention should be paid to these nodules.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100657"},"PeriodicalIF":2.2000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinics","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1807593225000821","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
Objective
To determine the malignancy risk of thyroid nodules with Isolated Macrocalcifications (IMC) based on surgical results and evaluate the postoperative risk of malignant nodules with IMC.
Methods
A total of 46 thyroid nodules with IMC were enrolled from 3680 consecutive patients who underwent thyroidectomy between August 2018 and September 2023. The malignancy risk of IMC nodules, postoperative risk of malignant nodules, and whether the ultrasonic features of IMC (smooth, lobulated, or focal disruption of the anterior margin) were associated with malignancy were investigated. The nodules were further divided into three groups (group A, maximum diameter < 10 mm; group B, maximum diameter of 10‒14 mm and group C, maximum diameter ≥ 15 mm). Differences in malignancy and Lymph Node Metastasis (LNM) risks were also evaluated among the three groups.
Results
The malignancy risk of the IMC nodules was 30.43% (14/46). Four patients developed LNM. Eight nodules were staged as T1aN0M0 and low-risk, whereas six nodules were staged as T1bN1aM0 and intermediate-risk. Focal disruption of the anterior margin of IMC was significantly associated with malignancy. Malignant and LNM risk showed no differences among nodules with different sizes.
Conclusions
IMC nodules with different sizes had a lower intermediate risk of malignancy and exhibited the same aggressive behavior. The cutoff value of these nodules for further Fine Needle Aspiration (FNA) warranted further investigation. Interruption of IMC was more often seen in malignant nodules, and more attention should be paid to these nodules.
期刊介绍:
CLINICS is an electronic journal that publishes peer-reviewed articles in continuous flow, of interest to clinicians and researchers in the medical sciences. CLINICS complies with the policies of funding agencies which request or require deposition of the published articles that they fund into publicly available databases. CLINICS supports the position of the International Committee of Medical Journal Editors (ICMJE) on trial registration.