Kassia B. Reuters
Kassia B. Reuters
Thyroid Diseases Center and Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
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Maria C.O.C. Mamone
Maria C.O.C. Mamone
Thyroid Diseases Center and Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
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Elsa S. Ikejiri
Elsa S. Ikejiri
Thyroid Diseases Center and Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
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Cleber P. Camacho
Cleber P. Camacho
Thyroid Diseases Center and Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
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Claudia C.D. Nakabashi
Claudia C.D. Nakabashi
Thyroid Diseases Center and Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
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Carolina C.P.S. Janovsky
Carolina C.P.S. Janovsky
Thyroid Diseases Center and Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
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Ji H. Yang
Ji H. Yang
Thyroid Diseases Center and Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
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Danielle M. Andreoni
Danielle M. Andreoni
Thyroid Diseases Center and Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
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Rosalia Padovani
Rosalia Padovani
Thyroid Diseases Center and Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
Santa Casa de São Paulo, São Paulo, Brazil
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Santa Casa de São Paulo, São Paulo, Brazil
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Rui M.B. Maciel
Rui M.B. Maciel
Thyroid Diseases Center and Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
Fleury Medicina e Saúde, São Paulo, Brazil
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Fleury Medicina e Saúde, São Paulo, Brazil
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Felipe A.B. Vanderlei
Felipe A.B. Vanderlei
Head and Neck Division, Department of Otorhinolaryngology and Head and Neck Surgery, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
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Rosa P.M. Biscolla
Rosa P.M. Biscolla
Thyroid Diseases Center and Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
Fleury Medicina e Saúde, São Paulo, Brazil
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Fleury Medicina e Saúde, São Paulo, Brazil
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used to distinguish between benign and malignant lesions [ 3 , 4 ]. In general, a cytological analysis with fine-needle aspiration (FNA) under US guidance is recommended for nodules with intermediate or highly suspicious sonographic patterns and with
Roberto Negro
Roberto Negro
Division of Endocrinology, “V. Fazzi” Hospital, Lecce
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Roberto Attanasio
Roberto Attanasio
Endocrinology Service, Galeazzi Institute IRCCS, Milan
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Franco Grimaldi
Franco Grimaldi
Endocrinology and Metabolic Disease Unit, Azienda Ospedaliero-Universitaria “S. Maria della Misericordia,” Udine
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Andrea Frasoldati
Andrea Frasoldati
Division of Endocrinology, IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia
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Rinaldo Guglielmi
Rinaldo Guglielmi
Department of Endocrinology, Regina Apostolorum Hospital, Albano Laziale, Italy
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Enrico Papini
Enrico Papini
Department of Endocrinology, Regina Apostolorum Hospital, Albano Laziale, Italy
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techniques reveals an epidemic of nonpalpable thyroid nodules that necessitate a complete workup, including US, testing for thyroid-stimulating hormone, and fine-needle aspiration (FNA) [ 3 ]. The first objective in thyroid nodule evaluation is to exclude
Mafalda Marcelino
Mafalda Marcelino
Department of Endocrinology, Armed Forces University Hospital, Lisbon, Portugal
Department of Endocrinology, Portuguese Institute of Oncology, Lisbon, Portugal
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Department of Endocrinology, Portuguese Institute of Oncology, Lisbon, Portugal
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Pedro Marques
Pedro Marques
Department of Endocrinology, Portuguese Institute of Oncology, Lisbon, Portugal
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Luis Lopes
Luis Lopes
Department of Endocrinology, Armed Forces University Hospital, Lisbon, Portugal
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Valeriano Leite
Valeriano Leite
Department of Endocrinology, Portuguese Institute of Oncology, Lisbon, Portugal
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João Jácome de Castro
João Jácome de Castro
Department of Endocrinology, Armed Forces University Hospital, Lisbon, Portugal
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, and fine-needle aspiration biopsy (FNAB) represent the standard for the management of thyroid nodules. Exceptions to this rule are hot (hyperfunctioning) nodules, which rarely represent clinically significant malignant lesions and therefore do not
Haggi Mazeh
Haggi Mazeh
Department of Surgery, Jerusalem, Israel
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Amir Orlev
Amir Orlev
Department of Surgery, Jerusalem, Israel
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Ido Mizrahi
Ido Mizrahi
Department of Surgery, Jerusalem, Israel
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David J. Gross
David J. Gross
Endocrinology and Metabolism Service Hadassah-Hebrew University Medical Center, Jerusalem, Israel
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Herbert R. Freund
Herbert R. Freund
Department of Surgery, Jerusalem, Israel
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× 28 mm. Fine-needle aspiration of this nodule revealed a follicular lesion (Bethesda classification IV). A 131 I thyroid scan showed normal thyroid size without any hot or cold nodules. The patient elected to undergo a total thyroidectomy which was
Gilles Russ
Gilles Russ
Thyroid and Endocrine Tumor Unit, Department of Nuclear Medicine, Pitié Salpêtrière Hospital, University Pierre et Marie Curie, Paris, France
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Sophie Leboulleux
Sophie Leboulleux
Department of Nuclear Medicine and Endocrine Oncology, Institut Gustave Roussy, University Paris-Sud, Villejuif, France
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Laurence Leenhardt
Laurence Leenhardt
Thyroid and Endocrine Tumor Unit, Department of Nuclear Medicine, Pitié Salpêtrière Hospital, University Pierre et Marie Curie, Paris, France
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Laszlo Hegedüs
Laszlo Hegedüs
Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark
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system) classification. The second part deals with the indications for US fine-needle aspiration biopsy (FNA), addresses specifically the problem of subcentimetric incidentalomas and microcarcinomas, and finally discusses the potential of nonsurgical
Maria Mavromati
Maria Mavromati
Department of Endocrinology, Diabetology, Nutrition and Therapeutic Education, Geneva University Hospitals, Rue Gabrielle Perret Gentil, Geneva University, Geneva, Switzerland
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Essia Saiji
Essia Saiji
Department of Pathology, Geneva University Hospitals, Rue Gabrielle Perret Gentil, Geneva, Switzerland
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Marco Stefano Demarchi
Marco Stefano Demarchi
Department of Endocrine Surgery, Geneva University Hospitals, Rue Gabrielle Perret Gentil, Geneva, Switzerland
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Vincent Lenoir
Vincent Lenoir
Department of Radiology, Geneva University Hospitals, Rue Gabrielle Perret Gentil, Geneva, Switzerland
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Amanda Seipel
Amanda Seipel
Department of Pathology, Geneva University Hospitals, Rue Gabrielle Perret Gentil, Geneva, Switzerland
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Paulina Kuczma
Paulina Kuczma
Department of Endocrine Surgery, Geneva University Hospitals, Rue Gabrielle Perret Gentil, Geneva, Switzerland
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François R Jornayvaz
François R Jornayvaz
Department of Endocrinology, Diabetology, Nutrition and Therapeutic Education, Geneva University Hospitals, Rue Gabrielle Perret Gentil, Geneva University, Geneva, Switzerland
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Minerva Becker
Minerva Becker
Department of Radiology, Geneva University Hospitals, Rue Gabrielle Perret Gentil, Geneva, Switzerland
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Eugenio Fernandez
Eugenio Fernandez
Department of Oncology, Geneva University Hospitals, Rue Gabrielle Perret Gentil, Geneva, Switzerland
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Claudio De Vito
Claudio De Vito
Department of Pathology, Geneva University Hospitals, Rue Gabrielle Perret Gentil, Geneva, Switzerland
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Frédéric Triponez
Frédéric Triponez
Department of Endocrine Surgery, Geneva University Hospitals, Rue Gabrielle Perret Gentil, Geneva, Switzerland
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Sophie Leboulleux
Sophie Leboulleux
Department of Endocrinology, Diabetology, Nutrition and Therapeutic Education, Geneva University Hospitals, Rue Gabrielle Perret Gentil, Geneva University, Geneva, Switzerland
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with surgery, active surveillance, or local treatment, depending on the size of the nodule ( 3 , 4 , 5 , 6 ). Given the high rate of thyroid nodules, most of which are benign, to reduce fine needle aspiration cytology (FNAC) and unnecessary surgery
Gilles Russ
Gilles Russ
Thyroid and Endocrine Tumors, Institute of Endocrinology, Pitié Salpêtrière Hospital, Pierre and Marie Curie University, Paris, France
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Steen J. Bonnema
Steen J. Bonnema
Department of Endocrinology, Odense University Hospital, Odense, Denmark
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Murat Faik Erdogan
Murat Faik Erdogan
Department of Endocrinology and Metabolism, University of Ankara School of Medicine, İbni Sina Hastanesi, Ankara, Turkey
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Cosimo Durante
Cosimo Durante
Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
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Rose Ngu
Rose Ngu
Head Neck and Thyroid Imaging, Department of Radiology, Guy’s and St Thomas’ Hospitals NHS Foundation Trust, London, United Kingdom
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Laurence Leenhardt
Laurence Leenhardt
Thyroid and Endocrine Tumors, Institute of Endocrinology, Pitié Salpêtrière Hospital, Pierre and Marie Curie University, Paris, France
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]. The goal of an initial sonographic assessment of thyroid nodules is to distinguish benign nodules that can be managed conservatively from those with suspicious or malignant features requiring further management. Fine needle aspiration (FNA) plays a
Ana Isabel Álvarez-Mancha
Ana Isabel Álvarez-Mancha
Department of Medicine, University of Malaga, Malaga, Spain
Department of Pathology, General University Hospital of Ciudad Real, Ciudad Real, Spain
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Department of Pathology, General University Hospital of Ciudad Real, Ciudad Real, Spain
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Isabel Mancha-Doblas
Isabel Mancha-Doblas
Department of Medicine, University of Malaga, Malaga, Spain
Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga, Spain
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Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga, Spain
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María Molina-Vega
María Molina-Vega
Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga, Spain
The Biomedical Research Institute of Malaga and Platform in Nanomedicine (IBIMA-BIONAND Platform), University of Malaga, Malaga, Spain
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The Biomedical Research Institute of Malaga and Platform in Nanomedicine (IBIMA-BIONAND Platform), University of Malaga, Malaga, Spain
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Diego Fernández-García
Diego Fernández-García
Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga, Spain
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Ana María Gómez-Pérez
Ana María Gómez-Pérez
Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga, Spain
The Biomedical Research Institute of Malaga and Platform in Nanomedicine (IBIMA-BIONAND Platform), University of Malaga, Malaga, Spain
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The Biomedical Research Institute of Malaga and Platform in Nanomedicine (IBIMA-BIONAND Platform), University of Malaga, Malaga, Spain
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Elena Gallego-Domínguez
Elena Gallego-Domínguez
Department of Medicine, University of Malaga, Malaga, Spain
Department of Pathology, Virgen de la Victoria University Hospital, Málaga, Spain
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Department of Pathology, Virgen de la Victoria University Hospital, Málaga, Spain
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María Victoria Ortega-Jiménez
María Victoria Ortega-Jiménez
Department of Medicine, University of Malaga, Malaga, Spain
Department of Pathology, Virgen de la Victoria University Hospital, Málaga, Spain
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Department of Pathology, Virgen de la Victoria University Hospital, Málaga, Spain
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Isabel Hierro-Martín
Isabel Hierro-Martín
Department of Pathology, Virgen de la Victoria University Hospital, Málaga, Spain
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Francisco J Tinahones
Francisco J Tinahones
Department of Medicine, University of Malaga, Malaga, Spain
Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga, Spain
The Biomedical Research Institute of Malaga and Platform in Nanomedicine (IBIMA-BIONAND Platform), University of Malaga, Malaga, Spain
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Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga, Spain
The Biomedical Research Institute of Malaga and Platform in Nanomedicine (IBIMA-BIONAND Platform), University of Malaga, Malaga, Spain
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Introduction Clinical management of the thyroid nodules is based on a combination of clinical risk factors, functional status, ultrasound patterns, and cytologic findings when fine needle aspiration (FNA) is indicated ( 1 , 2 , 3 , 4 , 5
M Grussendorf
M Grussendorf
Department of Internal Medicine, University Hospital, Düsseldorf, Germany
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I Ruschenburg
I Ruschenburg
MVZ Wagnerstibbe Center for Cytology and Pathology, Einbeck, Germany
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G Brabant
G Brabant
Department of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, University of Manchester, Manchester, UK
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ultrasound (US) criteria and possibly fine-needle aspiration cytology (FNAC), malignancy rates may be overestimated and will not necessarily reflect the chances of a nodule being first diagnosed by palpation or imaging methods. On the other hand, ROM may as
Stamatina Ioakim
Stamatina Ioakim
CEDM, Centre of Endocrinology, Diabetes & Metabolism, Limassol, Cyprus
Medical School, University of Milan, Milan, Italy
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Medical School, University of Milan, Milan, Italy
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Akheel A Syed
Akheel A Syed
Department of Diabetes, Endocrinology & Obesity Medicine, Salford Royal NHS Foundation & University Teaching Trust, Salford, UK
Division of Diabetes, Endocrinology & Gastroenterology, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
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Division of Diabetes, Endocrinology & Gastroenterology, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
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George Zavros
George Zavros
CEDM, Centre of Endocrinology, Diabetes & Metabolism, Limassol, Cyprus
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Michalis Picolos
Michalis Picolos
Alithias Endocrinology Centre, Nicosia, Cyprus
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Luca Persani
Luca Persani
Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
Department of Endocrinology and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
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Department of Endocrinology and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
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Angelos Kyriacou
Angelos Kyriacou
CEDM, Centre of Endocrinology, Diabetes & Metabolism, Limassol, Cyprus
Department of Diabetes, Endocrinology & Obesity Medicine, Salford Royal NHS Foundation & University Teaching Trust, Salford, UK
Medical School, European University of Cyprus, Nicosia, Cyprus
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Department of Diabetes, Endocrinology & Obesity Medicine, Salford Royal NHS Foundation & University Teaching Trust, Salford, UK
Medical School, European University of Cyprus, Nicosia, Cyprus
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recurrence ( 5 ). As such, physicians managing thyroid nodules need to identify the patients with ‘clinically significant’ carcinomas without subjecting too many people to invasive procedures i.e. fine-needle aspiration (FNA) biopsies and thyroidectomies
