Thyroid Nodules: Preliminary Report from an Endocrine Clinic of North Central Florida

Program: Abstracts - Orals, Poster Previews, and Posters
Session: SAT 270-310-Thyroid Neoplasia (posters)
Saturday, April 2, 2016: 1:15 PM-3:15 PM
Exhibit/Poster Hall (BCEC)

Poster Board SAT 278
Arnold Vera*1, Ronald W. Morrison2, Kristina Kotenko1, Nicholas F. Ryan3, Eun Ji Lim4, Katelyn G. Kennedy4, Jinesh A. Gheewala4, Courtney C. Sparger4 and Hera Jamal4
1Vera Endocrine Associates, Inc., Daytona Beach, FL, 2Daytona State College, Daytona Beach, FL, 3Florida State University, 4Vera Endocrine Associates, Inc.
Background: Thyroid gland disorders from function abnormalities (sub-to overt clinical) and changes in size, shape (goiter, nodules) are relatively common across the world population. In iodine sufficient areas the incidence of Thyroid Nodules (TN) and differentiated thyroid cancer has been increased substantially (American Thyroid Association (ATA) 2006, 2009, and 2015 guidelines). In terms of the cause(s) or pathogenic role of other main known factors, environmental risks should be added. In this preliminary report our purpose is to present the possible association (Epidemiological) of underground/well water intake that may contribute to the development of TN and/or neoplasm.

Methods and Results: An observational study in a personalized fashion of 756 patients, 611 (80.82%) Females and 145 (19.18%) Males, stratified by age groups as follows: 18-39.9, 40-59.9, 60 and older, who underwent standard Clinical and Laboratory care, Ultrasound (ATA criteria) and Fine Needle Aspiration Biopsy (pathology report according to Bethesda classification) was conducted at a general Endocrine Clinic of North Central Florida. The question of drinking underground/well water was also posed. 229 (57.68%), out of 397 surveyed patients, responded positively to the question.

On the Ultrasound findings nodules were located on both right and left sides, had an increased Doppler flow, and well defined margins. Microcalcification, Echogenicity, majority of nodules were hypoechoic, and heterogeneous/cyst. Average dimensions in centimeters of the right nodule were 1.36 (SAG) by 1.08 (TRV) by 1.05 (AP), and left nodule 1.49 (SAG) by 1.19 (TRV) by 1.2 (AP).

There were 53 females between ages of 18-39.9. Biopsy of their nodules showed result of 68.33% benign, 16.67% AUS/FLUSA, 1.67% follicular neoplasm, and 3.33% suspicious or malignant. Nodules of 4 males between ages of 18-39.9, were 50% benign, and 50% AUS/FLUSA. Out of 196 females, ages 40-59.9, nodules were 78.7% benign, 7.92% AUS/FLUSA, 1.49% follicular neoplasm, and 3.47% suspicious or malignant. Nodules of 44 males ages 40-59.9 were 77.77% benign, and 11% AUS/FLUSA. Out of 328 females ages 60 and older, nodules were 75.39% benign, 7.79% AUS/FLUSA, 2.18% follicular neoplasm, and 1.25% suspicious or malignant. Nodules of 89 males, ages 60 and older, were 66.27% benign, 9.64% AUS/FLUSA, 1.2% follicular neoplasm, and 2.4% suspicious or malignant.

Conclusions: The results of this study show that a significant number of patients who developed thyroid nodules responded positively to the question of drinking underground/well water. Based on these results, further research that investigates the correlation, and thus, the possible role that underground/well water plays in the development of thyroid nodules should be conducted.

Nothing to Disclose: AV, RWM, KK, NFR, EJL, KGK, JAG, CCS, HJ

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