NODULI TIROIDEI NELL'ACROMEGALIA: RUOLO DELL'ELASTOSONOGRAFIA

Objective: Ultrasound-elastography (US-E) appears to be a helpful tool for the diagnosis of thyroid cancer. In acromegaly multinodular goiter is a common occurrence while the prevalence of thyroid cancer is still debated. Aims were to evaluate thyroid nodules in acromegaly and to establish the accuracy of US-E in providing information on their nature, using cytological analysis as a reference. Subjects and Methods: US-E was applied to 90 nodules detected in 25 acromegalic patients and to 94 nodules found in 31 non acromegalic goitrous subjects. The lesions were classified according to the elastographic scores (ES) as soft (ES 1-2) or hard (ES 3-4). FNAC could be performed in 60.8% of hard nodules in acromegalic patients and in 86.7% of hard nodules in controls. Results: The prevalence of hard nodules in patients with active acromegaly (68.9%) was greater, though not to a statistically significant extent, than that observed in cured (44.4%) and controlled (52.5%) patients. Citology revealed malignancy or suspect malignancy in none of the nodules of acromegalic patients. Conclusions: This study has demonstrated a high prevalence of stiff thyroid nodules in acromegaly, greater than that found in non acromegalic goitrous subjects. Such nodules, appeared not to be malignant and are probably of fibrous nature. Thus, US-E appears to be of limited value for the diagnosis of thyroid cancer in acromegaly.