Download PDF
Exp Clin Endocrinol Diabetes 2005; 113(3): 152-159
DOI: 10.1055/s-2005-837523
Article

J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Questionnaire on Management of Nodular Thyroid Disease (Annual Meeting of the Thyroid Section of the German Society of Endocrinology 2003)

D. Führer1 , C. Mügge1 , R. Paschke1
  • 1IIIrd Medical Department, University of Leipzig, Leipzig, Germany
Further Information

Publication History

Received: May 24, 2004 First decision: July 21, 2004

Accepted: September 9, 2004

Publication Date:
23 March 2005 (online)

Also available at
    Permissions and Reprints

Abstract

Nodular thyroid disease is highly prevalent in iodine deficient areas. In Germany it affects approximately 30 % of the adult population. Differential diagnosis of thyroid nodules is directed at exclusion of rare thyroid malignancy and assessment of the nodules' functional characteristics in order to determine the best treatment approach.

In 2003 the annual meeting of the Sektion Schilddrüse, a thyroid specialist group of the German Society of Endocrinology addressed the topic of “management of benign nodular thyroid disease”. To assess the current diagnostic and therapeutic approach to nodular thyroid disease by German thyroid experts we designed a questionnaire, which was sent to all members of the Thyroid Section before the meeting and was answered by 70 % of the participants. We here report the results of the questionnaire, which show a considerable national heterogeneity in the management of thyroid nodules as well as diagnostic and treatment preferences for different thyroid specialist subgroups, e.g. endocrinologists and nuclear medicine specialist. This is in agreement with results of previous questionnaires assessing state-of-the-art practise among members of the European and American Thyroid Associations and underlines the definite need for a consensus process and for carefully planned randomized trials to answer the many unresolved questions in diagnosis and therapy of nodular thyroid disease.

Key words

Thyroid nodule - ultrasound - scintiscan - FNAC - medical treatment

References

  • 1 Alexander E K, Hurwitz S, Heering J P, Benson C B, Frates M C, Doubilet P M, Cibas E S, Larsen P R, Marqusee E. Natural history of benign solid and cystic thyroid nodules.  Ann Intern Med. 2003;  138 315-318
    CrossrefPubMedGoogle Scholar
  • 2 Bennedbaek F N, Perrild H, Hegedus L. Diagnosis and treatment of the solitary thyroid nodule. Results of a European survey.  Clin Endocrinol. 2000 a;  50 357-363
    PubMedGoogle Scholar
  • 3 Bennedbaek F N, Hegedus L. Management of the solitary thyroid nodules results of a North American Survey.  J Clin Endocrinol Metab. 2000 b;  85 2493-2498
    CrossrefPubMedGoogle Scholar
  • 4 Bonnema S J, Bennedbaek F N, Wiersinga W M. Management of the nontoxic multinodular goitre: a European questionnaire study.  Clin Endocrinol. 2000;  53 5-12
    CrossrefPubMedGoogle Scholar
  • 5 Bonnema S J, Bennedbaek F N, Ladenson P W, Hegedus L. Management of the nontoxic multinodular goiter: a North American survey.  J Clin Endocrinol Metab. 2002;  87 112-117
    CrossrefPubMedGoogle Scholar
  • 6 Brauer V F, Hentschel B, Paschke R. Euthyroid thyroid nodules. Aims, results and perspectives concerning drug therapy.  Dtsch Med Wochenschr. 2003;  128 2381-2387
    Article in Thieme ConnectPubMedGoogle Scholar
  • 7 Castro M R, Caraballo P J, Morris J C. Effectiveness of thyroid hormone suppressive therapy in benign solitary thyroid nodules: a meta-analysis.  J Clin Endocrinol Metab. 2002;  87 4154-4159
    PubMedGoogle Scholar
  • 8 Dietlein M, Dressler J, Grunwald F, Joseph K, Leisner B, Moser E, Reiners C, Rendl J, Schicha H, Schneider P, Schober O. Deutsche Gesellschaft für Nuklearmedizin . Guideline for in vivo and in vitro procedures for thyroid diseases (version 2).  Nuklearmedizin. 2003;  42 109-115
    PubMedGoogle Scholar
  • 9 Franklyn J A. Commentary: Lack of consensus in Europe in the management of nontoxic multinodular goitre.  Clin Endocrinol. 2000;  53 3-4
    CrossrefPubMedGoogle Scholar
  • 10 Hampel R, Kulberg T, Klein K, Jerichow J U, Pichmann E G, Clausen V, Schmidt I. Goiter incidence in Germany is greater than previously suspected.  ed Klin. 1995;  90 324-329
    PubMedGoogle Scholar
  • 11 Hegedus L, Bonnema S J, Bennedbaek F N. Management of simple nodular goiter: current status and future perspectives.  Endocr Rev. 2003;  24 102-132
    CrossrefPubMedGoogle Scholar
  • 12 Kahaly G J, Dietlein M. Cost estimation of thyroid disorders in Germany.  Thyroid. 2002;  12 909-914
    CrossrefPubMedGoogle Scholar
  • 13 Karges W, Dralle H, Raue F, Mann K, Reiners C, Grussendorf M, Hufner M, Niederle B, Brabant G. Calcitonin measurement to detect medullary thyroid carcinoma in nodular goiter: German evidence-based consensus recommendation.  Exp Clin Endocrinol Diabetes. 2004;  112 52-58
    Article in Thieme ConnectPubMedGoogle Scholar
  • 14 Knudsen N, Laurberg P, Perrild H, Bulow I, Ovesen L, Jorgensen T. Risk factors for goiter and thyroid nodules.  Thyroid. 2002;  12 879-888
    CrossrefPubMedGoogle Scholar
  • 15 Krohn K, Fuhrer D, Bayer Y, Eszlinger M, Brauer V, Neumann S, Paschke R. Molecular pathogenesis of euthyroid and toxic multinodular goiter.  . 2004;  submitted
    PubMedGoogle Scholar
  • 16 Mazzaferri E L. Thyroid cancer in thyroid nodules: finding a needle in the haystack.  Am J Med. 1992;  93 359-362
    CrossrefPubMedGoogle Scholar
  • 17 Mazzaferri E L. Management of a solitary thyroid nodule.  N Engl J Med. 1993;  328 553-559
    CrossrefPubMedGoogle Scholar
  • 18 Ortiz R, Hupart K H, DeFesi C R, Surks M I. Effect of early referral to an endocrinologist on efficiency and cost of evaluation and development of treatment plan in patients with thyroid nodules.  J Clin Endocrinol Metab. 1998;  83 3803-3807
    CrossrefPubMedGoogle Scholar
  • 19 Papini E. The dilemma of non-palpable thyroid nodules.  J Endocrinol Invest. 2003;  26 3-4
    PubMedGoogle Scholar
  • 20 Rojeski M T, Gharib H. Nodular thyroid diesase. evaluation and management.  N Engl J Med. 1985;  313 428-436
    PubMedGoogle Scholar
  • 21 Saller B, Esser H, Horn K. et al . Diagnostik und Therapie von Schilddrüsenkrankheiten. Empfehlungen zur Qualitätssicherung.  Der Internist. 1997;  38 177-185
    PubMedGoogle Scholar
  • 22 Singer A, Cooper D S, Daniels G H, Ladenson P W, Greenspan F S, Levy E G, Braverman L E, Clark O H, McDougall I R, Ain K V, Dorfman S G. Treatment guidelines for patients with thyroid nodules and well-differentiated thyroid cancer.  Arch Intern Med. 1996;  156 2165-2172
    PubMedGoogle Scholar
  • 23 Surks M I, Ortiz E, Daniels G H, Sawin C T, Col N F, Cobin R H, Franklyn J A, Hershman J M, Burman K D, Denke M A, Gorman Cooper R S, Weissman N J. Subclinical thyroid disease: scientific review and guidelines for diagnosis and management.  JAMA. 2004;  291 228-238
    CrossrefPubMedGoogle Scholar
  • 24 Tan G H, Gharib H. Thyroid incidentalomas: management approaches to nonpalpable nodules discovered incidentally on thyroid imaging.  Ann Intern Med. 1997;  126 226-231
    PubMedGoogle Scholar
  • 25 Topliss D. Thyroid incidentaloma: the ignorant in pursuit of the inpalpable.  Clin Endocrinol (Oxf). 2004;  60 18-20
    CrossrefPubMedGoogle Scholar
  • 26 Volzke H, Ludemann J, Robinson D M, Spieker K W, Schwahn C, Kramer A, John U, Meng W. The prevalence of undiagnosed thyroid disorders in a previously iodine-deficient area.  Thyroid. 2003;  13 803-810
    CrossrefPubMedGoogle Scholar

Prof. Dr. med. R. Paschke

Medizinische Klinik III
Universität Leipzig

Ph.-Rosenthal-Str. 27

04103 Leipzig

Germany

Phone: + 4903419713200

Fax: + 49 0 34 19 71 32 09

Email: pasr@medizin.uni-leipzig.de

      >