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Nodular disease during pregnancy

R P Walker1, A M Lawrence, E Paloyan

  • 1Department of Otolaryngology/Head and Neck Surgery, Loyola University Medical Center, Maywood, Illinois.

The Surgical Clinics of North America
|February 1, 1995
PubMed
Summary
This summary is machine-generated.

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Thyroid nodular disease during pregnancy requires urgent evaluation. Pregnancy can accelerate thyroid cancer growth, necessitating prompt surgical intervention, often in the second trimester or postpartum.

Area of Science:

  • Endocrinology
  • Oncology
  • Obstetrics

Background:

  • Autoimmune thyroid disease affects nearly 10% of women and can predispose to thyroid neoplasia.
  • Pregnancy involves hormonal changes and immunologic factors that may influence thyroid nodule development and growth.

Observation:

  • Thyroid nodular disease is common during pregnancy, with a significant incidence of neoplasia (80% in one study).
  • Pregnancy can exacerbate nodular thyroid disease, with 20% of patients experiencing marked growth, including potentially aggressive thyroid cancer.

Findings:

  • Thyroid carcinoma incidence was 43% and adenoma 37% in pregnant patients with thyroid neoplasia.
  • Rapid nodule growth during pregnancy, even with treatment, can indicate aggressive papillary carcinoma with occult metastatic disease.

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Implications:

  • Thyroid nodular disease with suspicious cytologic features during pregnancy warrants urgent management.
  • Surgical treatment for thyroid neoplasia during pregnancy is recommended either in the second trimester or immediately postpartum.