Clinical Study of Solitary Nodule of Thyroid at Tertiary Health Centre

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Authors

  • Professor and Head, Department of Surgery, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Adgaon - 422203, Nashik, Maharashtra ,IN
  • PG Resident, Department of Surgery, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Adgaon - 422203, Nashik, Maharashtra ,IN

DOI:

https://doi.org/10.18311/mvpjms/2019/v6i1/18365

Keywords:

Euthyroid, Malignancy, Solitary Nodule
Thyroid

Abstract

Introduction: Solitary nodule of thyroid has increased in incidence in the present day as compared to two decades before. Because of possibility of malignancy, some clinicians especially those in surgical subspecialties recommended that all nodules have to be removed. Material and Methods: Data collection by meticulous history taking and clinical examination, appropriate laboratory and radiological investigations, operative findings, histopathological report and follow-up of cases. Results: Study was conducted with 35 patients. The peak incidence of solitary thyroid nodule was observed in 3rd to 4th decade with four times more common in females as compared to male. The common causes of solitary thyroid nodule were colloid goitre (31.4%), Multinodular goitre (20%) and adenomatous goiter (17.1%), 94% of cases presented with euthyroid state. Incidence of malignancy in solitary thyroid nodule was 23%. The most common cause of malignancy was papillary carcinoma (14.3%). Conclusion: Solitary thyroid nodule is more common in 3rd to 4th decades. Solitary thyroid nodule is more common in females. Most of the patients presenting with solitary thyroid nodule are euthyroid and only a small percentage of patient with toxicity or hypothyroidism. USG can be accurately used to detect patients with multinodular goiter who clinically present as solitary thyroid nodule. Common causes of solitary thyroid nodule are colloid goitre, MNG, and adenomatous goiter. The most common cause of malignancy in solitary thyroid nodule is papillary carcinoma followed by follicular carcinoma.

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Published

2019-05-22

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Original Research Article

 

References

Cole WH, Majarakis JD. Incidence of carcinoma of thyroid in nodular goiter, J. Clin. Endocrinol. 1949; 9:1007−11. https://doi.org/10.1210/jcem-9-10-1007. PMid: 18142433.

Bentley AA, Gillespie C, Malis D. Evaluation and management of a solitary thyroid nodule in a child, Otolaryngol Clin. North Am. 2003; 36:117−28. https://doi.org/10.1016/S0030-6665(02)00131-7.

Harrison BJ, Maddox PR, Smith DM. Disorders of thyroid gland. In: Cuschieri A, Steele RJ, Moossa AR, editors. Essential Surgical Practice. 4th ed. London: Arnold; 2002. p. 95−110.

Dorairajan N,Jayashree N. Solitary nodule of the thyroid and the role of fine needle aspiration cytology in diagnosis, J. Indian Med. Assoc. 1996; 94:50−2,61.

Belfiore A, La Rosa GL. Fine-needle aspiration biopsy of the thyroid, Endocrinol Metab. Clin. North Am. 2001; 30:361−400. https://doi.org/10.1016/S08898529(05)70191-2.

Shyam Prasad Keshri. Clinico-Pathological Study of Solitary Thyroid Nodule with Special Reference to Fine Needle Aspiration Cytology, IJSR. 2017; 6(2):789−94.

Prakash H Muddegowda. Panoramic ultrasound of the thyroid, Int. J. Med. Health Sci. 2012; 1(1):19−23.

Sarda AK, Gupta A, Jain PK, Prasad S. Management options for solitary thyroid nodules in an endemic goitrous area, Postgrad. Med. J. 1997; 73:560−64. https://doi.org/10.1136/pgmj.73.863.560. PMid: 9373596, PMCid: PMC2431457.

Williams N, O'Connell PR, editors. Bailey and Love's Short Practice of Surgery 26E. Crc Press; 2013 Feb 18.

Boyd LA, Earnhardt RC, Dunn JT, et al. Preoperative evaluation and predictive values of fine needle aspiration and frozen section of thyroid nodules, J. Am. Coll. Surg. 1998; 187:494−502. https://doi.org/10.1016/S10727515(98)00221-X.

Fenn AS et al. Solitary thyroid nodules of thyroid gland- A review of 342 cases, Indian J. Surg. 1980 April; 42:175−77.

Zeki Acun MD, Mustafa Comert MD, Alper Cihan MD, Suat Can Ulukent MD, Bulent Ucan MD, Guldeniz

Karadeniz C. Akmak: Near-Total Thyroidectomy could be the best treatment for thyroid disease in endemic Regions, Arch. Surg. 2004; 139:444−47. https://doi.org/10.1001/archsurg.139.4.444. PMid: 15078715.

Tarrar AM, Wahla MS, Ilyas S, Khan OU, Waqas A, Raza A. Solitary Thyroid Nodule; Frequency of Malignancy at Combined Military Hospital Rawalpindi, Professional Medical Journal. 2010 Oct 1; 17(4).

Raza S, Saeed Z, Raza H, Ahmed M. FNAC in the management of solitary thyroid nodule, Profeessional Med. J. 2006; 13(4):596−603.

Sarfraz T, Ullah K, Muzaffar M. The frequency and histological types of thyroid carcinoma in northern Pakistan, Pak. Armed. Forces Med. J. 2000; 50(2):98−101.

Wong CK, Wheeler MH. Thyroid Nodules: Rational management, World J. Surg. 2000; 24:934−41. https://doi.org/10.1007/s002680010175. PMid:10865037.

Christensen SB, Bondeson L, Ericsson UB, Lindholm K. Prediction of malignancy in the solitary thyroid nodule by physical examination, thyroid scan, fine-needle biopsy and serum thyroglobulin. A prospective study of 100 surgically treated patients.

McCoy KL, Jabbour N, Ogilvie JB, Ohori NP, Carty SE, Yim JH. The incidence of cancer and rate of false-negative cytology in thyroid nodules greater than or equal to 4 cm in size, Surgery. 2007 Dec 31; 142(6):837−44. https://doi.org/10.1016/j.surg.2007.08.012. PMid: 18063065.

Moon WJ, Jung SL, Lee JH, Na DG, Baek JH, Lee YH, et al. Benign and malignant thyroid nodules: US differentiation− multicenter retrospective study, Radiology. June 2008; 247:762−70. https://doi.org/10.1148/radiol.2473070944. PMid: 18403624.

Takashima S, Fukuda H, Nomura N, Kishimoto H, Kim T, Kobayashi T. Thyroid nodules: Reevaluation with ultrasound, J. Clin. Ultrasound. 1995; 23(3):179−84. https://doi.org/10.1002/jcu.1870230306. PMid: 7730464.

Enrico Papini, Rinaldo Guglielmi, Antonio Bianchini, Anna Crescenzi et al. Risk of Malignancy in Nonpalpable Thyroid Nodules: Predictive Value of Ultrasound and ColorDoppler Features, The Journal of Clinical Endocrinology and Metabolism. May 1 2002; 87(5):1941−46. https://doi.org/10.1210/jc.87.5.1941.

Hamberger B, Gharib H, Melton LJ III, Goellner JR, Zinsmeister AR. Fine needle aspiration cytology of thyroid nodules: impact on thyroid practice and cost of care, Am. J. Med. 1982; 73:381−84. https://doi.org/10.1016/00029343(82)90731-8.

Kaur K, Sonkhya N, Bapna AS, Mital P. A comparative study of fine needle aspiration cytology, ultrasonography and radionuclide scan in the management of solitary thyroid nodule: A prospective analysis of fifty cases, Ind. J. Otolaryngol head neck surg. 2002 June; 54(2):96−101.

Mundasad B, Mcallister I, Carson J, Pyper P. Accuracy of fine needle aspiration cytology indiagnosis of thyroid swellings, Internet J. Endocrinol. 2006; 2(2):15−19. https://doi.org/10.5580/484.