Introduction: American Thyroid Association recommends that benign thyroid nodules should be revaluated 618 months after initial FNA and in case of stability the follow-up should be 35 years. However there isnt any consensus about the periodicity of the follow-up.
Aim: To evaluate the nodules in terms of function, size and malignancy in a 10-year follow-up.
Methods: Retrospective study of 347 patients (543 benign thyroid nodules) followed in consultation. Inclusion criteria: follow-up ≥10 years; normal thyroid function; Initial benign FNAC. Evaluation at 5 and 10 years of the following parameters: size, growth (>20% diameter and at least 2 mm in two dimensions), cytology, thyroid function, and therapeutic approach. The variables were analysed by methods of descriptive statistics: frequency tables and contingency for categorical variables and mean, S.D., minimum, and maximum for continuous variables.
Results: We included for analysis 441 nodules of 282 patients, 71% females, mean 56.3±13.1 years old. The average of nodules size were 18.9±12.1 mm in the first evaluation. In 5 years 29.45% had increased (mean 9.91±8.46 mm) and decreased 19.1% (average 8.81±4.85 mm). In 10 years 31.5% had increased (average 11.53±7.31 mm) and 15.7% decreased (6.84±4.83 mm). None of the evaluated nodules turned hyperfunctioning. 17.1% of the evaluated nodules were submitted to surgery, 72% of which for its size (>40 mm or compressive complaints) and the rest by cytological abnormalities. 28% of the nodules revealed to be malignant (4.79% of total).
Conclusions: In this study it was found that about 1/3 of nodules increased in size and 4.79% revealed to be malignant, even with a previous benign cytology. Our results favour a monitoring and a FNAC repetition of the nodules during follow-up, an usual practice in our department.