Diagnostic Value of Calcifications in the Thyroid Gland

Objective: To evaluate the significance of sonographically detected thyroid calcifications in the diagnosis of thyroid cancer. Rationale: Calcifications are frequently detected in thyroid disease. Many published reports emphasize the importance of detecting thyroid calcifications because in many cases it raises the suspicion of malignancy. Methods: Seventy patients with thyroid disease, including 14 with thyroid cancer, were included in the study. Each patient underwent thyroid sonography and fine-needle aspiration biopsy (FNAB). Results: The highest incidence of calcification was found in thyroid cancer (57%), followed by multinodular goiter (37%), solitary nodular goiter (13%) and follicular adenomas (11%). The incidence of cancer was significantly higher in patients with calcified nodules (32%) than in those without calcifications (13%); p 0.05. In the group of solitary thyroid nodules, the incidence of cancer in the calcified nodules (63%) was higher than in the nodules without calcification (23%); p 0.05. Multiple non-calcified thyroid nodules harbored cancer in only 4% of cases. Patients younger than 40 years with calcified nodules constituted a high-risk group, in comparison with patients older than 40 years with calcified nodules. Conclusions: Detection of thyroid calcifications by sonography is diagnostically valuable, especially in cases involving a solitary nodule or a young person. The presence of calcifications in these cases should raise the suspicion of malignancy. The low incidence of cancer in patients with multiple noncalcified thyroid nodules suggests that a more conservative approach may be appropriate in such cases.