Estado actual de la evaluación y el tratamiento del nódulo tiroideo

  1. N. Muñoz Pérez 1
  2. J. Villar del Moral 1
  3. E. Corral Fernández 1
  4. J. Valdivia Risco 1
  5. J. Avella Vega 1
  6. J. I. Arcelus Martínez 1
  7. J. A. Ferrón Orihuela 1
  1. 1 Hospital Universitario Virgen de las Nieves. Servicio de Cirugía General. Sección de Cirugía Endocrina
Revista:
Cirugía Andaluza

ISSN: 2695-3811,  1130-3212

Año de publicación: 2014

Volumen: 25

Número: 1

Páginas: 6-16

Tipo: Artículo

DIALNET GOOGLE SCHOLAR lock_openDialnet editor

Otras publicaciones en: Cirugía Andaluza

Resumen

El nódulo tiroideo es muy prevalente en la población y su importancia clínica radica en la necesidad de identificar a aquel que pueda ser un cáncer. En la actualidad disponemos de dos herramientas diagnósticas, ecografía y punción aspiración con aguja fina (PAAF), que permiten la correcta catalogación de la mayoría de estas lesiones de forma eficiente. El desarrollo técnico de la ecografía no sólo ha aumentado el número de nódulos diagnosticados, sino que ha incrementado la rentabilidad de la PAAF, al disminuir el número de punciones no valorables. Por otro lado, se ha desarrollado un sistema para unificar la terminología utilizada por los citólogos en sus informes, proporcionando una información más precisa y comparable entre centros de tratamiento. Además de estas dos herramientas iniciales para el diagnóstico, se ha investigado en otros campos, destacando la continua búsqueda y el hallazgo de marcadores genéticos relacionados con el cáncer tiroideo, muchos de ellos analizados en muestras citológicas, especialmente cuando su resultado es sospechoso o indeterminado. En estos casos, se ha comprobado que la elastografía y la tomografía por emisión de positrones podrían ayudar a diferenciar nódulos benignos de malignos. El tratamiento recomendado es la extirpación quirúrgica (tiroidectomía total o hemitiroidectomía), en función del tamaño, los síntomas y el resultado de la citología. Sin embargo, también en este campo se ha evolucionado hacia una técnica menos invasiva (miniincisones, abordaje endoscópico o videoasistido) e incluso se están desarrollando técnicas no quirúrgicas: ablación con etanol, termoablación con láser, radiofrecuencia o ecografía de alta intensidad.

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Fuente de los datos: Dialnet