Thyroid nodule secondary prevention: Difference between revisions
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== Overview == | == Overview == | ||
[[Secondary prevention]] of a thyroid nodule is aimed at the [[Prevention (medical)|prevention]] of recurrence after removal of a primary nodule (specially in case of [[malignant]] lesions). Post-operative periodic monitoring with [[serum]] [[thyroglobulin]] levels, [[Radioactive iodine uptake|radioactive iodine scanning]], [[neck]] [[ultrasound]] and [[Thyroid-stimulating hormone|thyroid stimulating hormone]] ([[TSH]]) may decrease the chances of recurrence. | |||
== Thyroid Nodule Secondary Prevention == | == Thyroid Nodule Secondary Prevention == | ||
Secondary prevention of a thyroid nodule is aimed at the prevention of recurrence after removal of a primary nodule (specially in case of malignant lesions). The following steps outline the secondary prevention of malignant thyroid nodules: | [[Secondary prevention]] of a thyroid nodule is aimed at the [[Prevention (medical)|prevention]] of recurrence after removal of a primary nodule (specially in case of [[malignant]] lesions). The following steps outline the [[secondary prevention]] of [[malignant]] thyroid nodules: | ||
=== 1. Routine screening for disease recurrence === | === 1. Routine screening for disease recurrence === | ||
* Measurement of serum thyroglobulin levels after total thyroidectomy. | * Measurement of [[serum]] [[thyroglobulin]] levels after [[Thyroidectomy|total thyroidectomy]]. | ||
* Post-op diagnostic RAI scanning | * Post-op diagnostic [[RAIU|radioactive iodine (RAI) scanning]] | ||
* Post-op ultrasound | * Post-op [[neck]] [[ultrasound]] | ||
=== 2. Serum TSH goals === | === 2. Serum TSH goals === | ||
* Maintain TSH levels between: | * Maintain [[Thyroid-stimulating hormone|TSH]] levels between: | ||
** Non-stimulated thyroglobulin < 0.2 ng/ml : TSH should be 0.5-2.0 mU/L | ** Non-stimulated [[thyroglobulin]] < 0.2 ng/ml : TSH should be 0.5-2.0 mU/L | ||
** Non-stimulated thyroglobulin greater than equal to 0.2 ng/ml: TSH should be 0.1-0.5 mU/L | ** Non-stimulated [[thyroglobulin]] greater than equal to 0.2 ng/ml: TSH should be 0.1-0.5 mU/L | ||
=== 3. Evaluation of response to therapy === | === 3. Evaluation of response to therapy === | ||
* Serum thyroglobulin levels | * [[Serum]] [[thyroglobulin]] levels | ||
* Neck ultrasound | * [[Neck]] [[ultrasound]] | ||
* Whole body scanning (not routinely indicated) | * Whole body scanning (not routinely indicated) | ||
=== 4a. Excellent response to therapy === | === 4a. Excellent response to therapy === | ||
* Primary follow-up with clinical exam and non-stimulated thyroglobulin levels (TSH goal 0.5-2 mU/L) | * Primary follow-up with clinical exam and non-stimulated [[thyroglobulin]] levels ([[Thyroid-stimulating hormone|TSH]] goal 0.5-2 mU/L) | ||
* Non-stimulated thyroglobulin levels at 12-24 month intervals | * Non-stimulated [[thyroglobulin]] levels at 12-24 month intervals | ||
* Periodic neck ultrasound | * Periodic [[neck]] [[ultrasound]] | ||
== References == | == References == | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 19:54, 1 November 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahshid Mir, M.D. [2]
Overview
Secondary prevention of a thyroid nodule is aimed at the prevention of recurrence after removal of a primary nodule (specially in case of malignant lesions). Post-operative periodic monitoring with serum thyroglobulin levels, radioactive iodine scanning, neck ultrasound and thyroid stimulating hormone (TSH) may decrease the chances of recurrence.
Thyroid Nodule Secondary Prevention
Secondary prevention of a thyroid nodule is aimed at the prevention of recurrence after removal of a primary nodule (specially in case of malignant lesions). The following steps outline the secondary prevention of malignant thyroid nodules:
1. Routine screening for disease recurrence
- Measurement of serum thyroglobulin levels after total thyroidectomy.
- Post-op diagnostic radioactive iodine (RAI) scanning
- Post-op neck ultrasound
2. Serum TSH goals
- Maintain TSH levels between:
- Non-stimulated thyroglobulin < 0.2 ng/ml : TSH should be 0.5-2.0 mU/L
- Non-stimulated thyroglobulin greater than equal to 0.2 ng/ml: TSH should be 0.1-0.5 mU/L
3. Evaluation of response to therapy
- Serum thyroglobulin levels
- Neck ultrasound
- Whole body scanning (not routinely indicated)
4a. Excellent response to therapy
- Primary follow-up with clinical exam and non-stimulated thyroglobulin levels (TSH goal 0.5-2 mU/L)
- Non-stimulated thyroglobulin levels at 12-24 month intervals
- Periodic neck ultrasound