DOI: http://dx.doi.org/10.18203/2349-2902.isj20190551

A clinical study of solitary nodule thyroid

Shashikala V., Archit Muralidhar, Anand Kuchinoor, Anand Suntan

Abstract


Background: A solitary Nodule Thyroid is a palpable swelling in an otherwise normal thyroid. It is noted to have a higher incidence of malignancy. The disease is seen to affect 4-7% of the total population with a predominance for females to males with a ratio of 4:1. A systemic approach is thus needed to evaluate and treat Solitary Nodule Thyroid.

Methods: A prospective study of 80 patients admitted with solitary nodule thyroid admitted to Bowring and Lady Curzon Hospital between September 2017 and November 2018. A detailed history and examination were carried out and routine investigations were sent. Hemi thyroidectomy was done in all patients.

Results: Peak incidence seen at the 3rd and 4th decades of life, with 73 females and 7 males. Most common was swelling in the thyroid region, with the duration being 1 month to 6 years. Right lobe to be involved in 52 of the total cases studied. Multinodular goitre is the most common cause of solitary nodule thyroid followed by follicular Adenoma. Most common malignancy noted was papillary carcinoma, followed by follicular carcinoma. All patients underwent hemi thyroidectomy. There was no mortality in our study.

Conclusions: Solitary nodule thyroid is a common clinical entity that occurs more commonly in females. Usually presents as a painless neck swelling. FNAC and thyroid profile are the most important investigations that help in its diagnosis. MNG is the most common cause of SNT. Surgery is the treatment of choice of all cases. Hemi thyroidectomy is the most appropriate and least expensive procedure that can be done for its treatment.


Keywords


Hemi thyroidectomy, Multinodular goiter, Solitary nodule, Thyroid

Full Text:

PDF

References


Unnikrishnan AG, Kalra S, Baruah M, Nair G, Nair V, Bantwal G, et al. Endocrine Society of India management guidelines for patients with thyroid nodules: A position statement. Indian J Endocrinol Metabolism. 2011 Jan;15(1):2.

Neki NS, Kazal HL. Solitary thyroid nodule-an insight. J Ind Acad Clin Med. 2006 Oct;7(4):328-3.

Papini E, Guglielmi R, Bianchini A, Crescenzi A, Taccogna S, Nardi F, et al. Risk of malignancy in nonpalpable thyroid nodules: predictive value of ultrasound and color-Doppler features. J Clin Endocrinol Metabolism. 2002 May 1;87(5):1941-6.

Okamoto T, Yamashita T, Harasawa A, Kanamuro T, Aiba M, Kawakami M, et al. Test performances of three diagnostic procedures in evaluating thyroid nodules. Endocrine J. 1994;41(3):243-7.

Khafagi F, Castles H, Perry‐Keene D, Mortimer R, Wright G. Screening for thyroid malignancy: the role of fine‐needle biopsy. Med J Australia. 1988 Sep;149(6):302-7.

Ananthakrishnan N, Rao KM, Narasimhan R, Veliath AJ. Single thyroid nodule, South Indian profile of 503 patients with special reference incidence of malignancy. Ind J Surg. 1993;55(10):487-92.

Puca E, Lumi E, Olldashi B, Bitri S, Ylli D, Ylli A, et al. Thyroid nodule size and the risk of malignancy. In: 19th European Congress of Endocrinology. 2017 May 3;49. BioScientifica.

Hajmanoochehri F, Rabiee E. FNAC accuracy in diagnosis of thyroid neoplasms considering all diagnostic categories of the Bethesda reporting system: A single-institute experience. J Cytol. 2015 Oct;32(4):238.

Bennedbæk FN, Perrild H, Hegedüs L. Diagnosis and treatment of the solitary thyroid nodule. Results of a European survey. Clin Endocrinol. 1999 Mar;50(3):357-63.

Prasad C, Kumar S. Comparative study on association between serum TSH concentration and thyroid cancer. Int Surg J. 2017 Jul 24;4(8):2800-5.