Management of the single thyroid nodule

2011 ◽  
pp. 595-600
Author(s):  
Laszlo Hegedüs ◽  
Finn N. Bennedbæk
Keyword(s):  
Thyroid Nodule ◽  
Thyroid Surgery ◽  
Main Concern ◽  
Thyroid Malignancy ◽  
Normal Gland ◽  
Solitary Thyroid Nodule ◽  
Euthyroid Patient ◽  
Surgery Management

The main concern of patients and physicians alike, when dealing with the solitary thyroid nodule, is to diagnose the few cancers (approximately 5%) as rapidly and cost-effectively as possible, and to reduce superfluous thyroid surgery. Management has changed in recent years, but differences prevail as shown by an investigation among European thyroidologists (1). This chapter focuses on the palpably discrete swelling within an otherwise normal gland in the clinically and biochemically euthyroid patient (2, 3). The toxic nodule is dealt with in Chapter 3.3.11, and thyroid malignancy in Chapters 3.5.4–3.5.7.

Patients’ Preferences’ Impact on Decision Making for Clinical Solitary Thyroid Nodule in a Global Healthcare Setting: A Clinical Study

2021 ◽  
Vol 3 (2) ◽  
pp. 48-58
Author(s):  
Abdalla Y Bashir ◽  
Keyword(s):  
Decision Making ◽  
Thyroid Nodule ◽  
Thyroid Surgery ◽  
Frozen Section ◽  
Management Strategies ◽  
Healthcare Setting ◽  
Objective Evaluation ◽  
Needle Aspiration ◽  
Solitary Thyroid Nodule ◽  
Risk Of Malignancy

Objective: Evaluation of patients’ preferences (PP) impact on decision-making for solitary thyroid nodule management. Study Design: A retrospective review of prospectively collected data in patients with clinical solitary nodules admitted for thyroid surgery. PP survey in various management strategies included determinants of surgery, fine-needle aspiration cytology (FNAC), frozen section (FS), and PP for total thyroidectomy (TT) or total lobectomy (TL) compared to guidelines concordance. Results: Thyroid surgery was performed for 558 patients, 75.8% were females and 43.7% were international. FNAC was done in 79.8% and refused by 20.2% due to the misperception that it spreads cancer. The risk of malignancy was the reason for choosing surgery in 35.1%. FS was preferred by 87% of the patients for decision-making (TT vs TL) in our setting with available pathology resources and low FS cost. FS based decisions were more guideline-concordant (79%) with TT performed in 41% patients compared to 74.4% in PP based decisions alone (P < 0.001). 57.9% of the patients preferred surgeon authorization for decision-making when FS was unavailable. Papillary thyroid carcinoma (PTC) occurred in 85.3%. FS diagnosed PTC in 79% of the patients with malignant nodules in inconclusive FNACs (Bethesda I, III, IV, and V). Conclusion: Decisions (TT vs TL) based on PP and beliefs compared to FS based decisions were less guideline-concordant (21% vs 79%) with more TT performed (74.4% vs 41%) (P < 0.001). Advancing patients’ knowledge on their disease, guidelines, and equipoise awareness is needed for better-shared decision-making.

scholarly journals Prevalence and pattern of thyroid malignancy in thyroid nodule in Aseer Central Hospital in KSA

2017 ◽  
Vol 3 (4) ◽  
pp. 908 ◽  
Author(s):  
Jibril Yahya Hudise ◽  
Khalid Ali Alshehri ◽  
Saad Nasser Alqarni ◽  
Yara Assiri ◽  
Ashwaq Asiri ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Thyroid Nodule ◽  
Cell Carcinoma ◽  
Thyroid Nodules ◽  
Follicular Thyroid Carcinoma ◽  
Papillary Thyroid ◽  
Thyroid Malignancy ◽  
Central Hospital ◽  
Medullary Thyroid

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Thyroid nodules are common in the general population, especially in women. Non palpable nodules are often found when patients undergo diagnostic imaging such as ultrasonogra­phy and computed tomography of the chest and neck. This retrospective study to assess the Prevalence of thyroid malignancy in thyroid nodule related to gender, age, and pathology, in Aseer Central Hospital KSA. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">During a 5-year period (2011–2016), the medical records of 319 patients with thyroid nodules were collected from the department of pathology at Aseer Central Hospital KSA. The cases were reviewed for data on gender, age, and the pathological result. All patients underwent hemi or total thyroidectomy. Comparisons between genders, age groups, and tissue origins were performed. All statistical tests were performed with SPSS software.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Over a period of 5 years, a total of 319 patients: male 17.2% and female 82.8% Underwent for hemi or total thyroidectomy. The age of presentation was ranging from 14 to 80 years. Among the 319 cases of thyroid nodules 73.7% were benign nodules and 26.3% malignant nodules. Papillary thyroid carcinoma in 72.6%, follicular thyroid carcinoma 10.6%, Hurthle cell carcinoma 4.8%, anaplastic carcinoma 4.8%, thyroid lymphoma 4.8% and medullary thyroid carcinoma in 2.4%. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Thyroid nodule is a common clinical problem and the proportion of such nodules that prove to be malignant is not small, investigations are of immense help to corroborate with the clinical and morphological finding. Papillary thyroid carcinoma most common malignant thyroid carcinoma followed by follicular thyroid carcinoma, hurthel cell carcinoma, anaplastic thyroid carcinoma, lymphoma and finally medullary thyroid Carcinoma. No significant different between male and female as risk factors for malignancy.</span></p>

scholarly journals Ultrasound Characterization of a Solitary Thyroid Nodule According to British Thyroid Association (BTA) - Derived Criteria: A Simple Test of Reliability on a Small Cohort

2021 ◽  
Vol 89 (6) ◽  
pp. 1063-1077
Author(s):  
LAMYA A. EISSA, M.D.; NOORALDEEN ALSAMAHI, M.S. ◽  
MOHAMED SAMY BARAKAT, M.D.; DINA ABDALLAH, M.D. ◽  
MUHAMMED MAHMOUD EL-SHAFEI, M.D.
Keyword(s):  
Thyroid Nodule ◽  
Simple Test ◽  
Solitary Thyroid Nodule ◽  
Small Cohort

scholarly journals Solitary thyroid nodule: an overview of one year study at a tertiary care hospital

2019 ◽  
Vol 6 (9) ◽  
pp. 3117
Author(s):  
Shyam Sundar Tandri ◽  
Ayathu V. S. Sai Mahesh
Keyword(s):  
Thyroid Nodule ◽  
Tertiary Care Hospital ◽  
Demographic Data ◽  
Tertiary Care ◽  
Common Finding ◽  
Clinical Approach ◽  
Care Hospital ◽  
Cross Sectional ◽  
Solitary Thyroid Nodule ◽  
One Year

Background: Thyroid nodules are a common finding in general practice. These nodules are either solitary or multinodular. In the present study thorough evaluation of all the cases presenting with a solitary thyroid nodule (STN) is done. The clear overview of prevalence of STN, associated risk factors, its distribution and its percentage of malignancy, clinic-pathological correlation and findings on ultra-sonogram.Methods: A one year cross sectional study at a tertiary care hospital was done after ethical committee approval. All cases of thyroid with solitary thyroid nodule were included and socio demographic data, clinical examination and USG data was noted. Thyroid hormone profile, FNAC and HPE was performed for every case enrolled and data was noted. The data was analyzed using SPSS version 22.Results: 350 cases were enrolled with 44.42% prevalence and 61.43% were females. Maximum age group was 31-40 years with swelling as the most common sign. 81.14% were euthyroid, 6.3% of cases had lymph node involvement. Micro calcification in 69.7% of nodules and 78.65 were solid. 40.3% of the STN were of colloid on FNAC and 6% were malignant. Malignancy on HPE was 14.6% and papillary carcinoma was the most commonest and follicular least.Conclusions: All cases of STN require a thorough clinical approach supported by ultra-sonogram, FNAC and detailed HPE after surgery for evaluation of benign and malignant lesions. Fine needle aspiration cytology has become an invaluable, minimally invasive and reliable tool in the preoperative assessment of patients with suspicion of malignancy.

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