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 Characterization of Thyroid Nodule by Sonographic Features

2018 ◽  
Vol 7 (1-2) ◽  
pp. 19-26
Author(s):  
Hensan Khadka ◽  
Saroj Sharma ◽  
Ram Kumar Ghimire ◽  
Gita Sayami
Keyword(s):  
Thyroid Nodule ◽  
Tertiary Care ◽  
Endocrine Gland ◽  
Care Hospital ◽  
Jugular Veins ◽  
Malignant Nodule ◽  
Solitary Thyroid Nodule ◽  
Egg Shell ◽  
Benign Nodules

Introduction:  The thyroid is an endocrine gland situated in the infrahyoid compartment of neck in a space outlined by muscle, trachea, esophagus, carotid arteries and jugular veins. Though nodular thyroid disease is relatively common, thyroid cancer is rare and accounts for less than 1% of all malignancies indicating that overwhelming majority of thyroid nodules are benign. The purpose of this study was to assess the sonographic characteristics in a solitary thyroid nodule and predict  risk of malignancy.Methods:  This prospective study was conducted in a tertiary care hospital in Kathmandu.62 patients with palpable thyroid nodule were evaluated for sonographic characteristics .USG guided FNA for cytopathological examination was then performed.Results: Out of 66 patients, four were subsequently excluded because they didn’t fulfill the inclusion criteria. Of the 62 patients, 47 (75.8%) were females and 15 (24.2%) were males. Among 56 benign nodules, 45 (80.4%) were in females and 11(19.6) were in male. Among 6 malignant nodules, 4(66.7%) were in males and 2 (33.3%) were in females. Result shows 5 malignant nodules (83.3%) were solid where as 1 malignant nodule (16.7%) was complex with solid predominance. All 4 cystic nodules (7.1%) were benign. All complex nodules with predomint cystic components were also benign. One malignant nodule (16.7%) had snow storm type of microcalcification.  None of the benign nodules had microcalcification. Nodule having microcalcification was malignant. Findings showed that all malignant nodules (100%) had increased internal vascularity whereas benign nodules were variable in internal vascularity.Conclusion: This study has shown that colloid goiter is the commonest benign diagnosis whereas papillary carcinoma is the commonest malignancy. Malignant nodules are solid or predominantly solid whereas cystic and predominantly cystic nodules are likely to be benign. Macrocalcification and internal vascularity are not reliable to differentiate benign from malignant nodule. However, snowstorm calcification makes a nodule likely to be malignant whereas egg shell calcification is characteristic for benign nodule.

scholarly journals B.05 Hemi-laryngopharyngeal spasm (HELPS) syndrome: The discovery, cure, and characterization of a new neurological condition

2017 ◽  
Vol 44 (S2) ◽  
pp. S11-S11
Author(s):  
C Honey ◽  
M Morrison
Keyword(s):  
Surgical Care ◽  
Review Of The Literature ◽  
The Past ◽  
First Case ◽  
Patient Reported ◽  
Operative Outcome ◽  
Small Cohort ◽  
The Common ◽  
Similar Motor

Background: We published the world’s first case of hemi-laryngpharyngeal spasm (HELPS) syndrome cured by microvascular decompression (MVD) of the Xth cranial nerve in 2016. We now present a small cohort of patients (n=3) successfully treated with surgery in order to better delineate the common characteristics of this syndrome, diagnostic tests of choice, nuances of their surgical care and outcomes of their treatment. Methods: The history and physical examination of three patients with HELPS syndrome are presented. Pre-operative laryngoscopy, neuroimaging, response to botox and intra-operative videos are detailed. Post-operative outcome and complications are presented. Results: Each patient reported similar motor (choking) and sensory (coughing) features in their history. Episodic choking relentlessly progressed over the years until it occurred while sleeping and with frightening severity prompting tracheostomy in one patient and intubation in another. A “tickling” sensation deep in the throat triggered episodic coughing that worsened over the years until it occurred while sleeping and with frightening severity (syncope and incontinence). Conclusions: A review of the literature suggests that patients with similar symptoms, often called episodic laryngospasm in the past, have been treated with psychotherapy or antacids. With the recognition that a clearly defined subset of these patients have HELPS syndrome, we can offer them the potential of a neurosurgical cure.

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.

A CLINICAL STUDY OF SOLITARY THYROID NODULE

2021 ◽  
pp. 15-16
Author(s):  
U. Shiva ◽  
M. Ramachandra
Keyword(s):  
Clinical Study ◽  
Thyroid Gland ◽  
Thyroid Nodule ◽  
Total Population ◽  
Nodular Goiter ◽  
Systemic Approach ◽  
Normal Thyroid ◽  
Male Ratio ◽  
Solitary Thyroid Nodule

A solitary thyroid nodule (STN) is dened as a palpable discreet swelling in an other wise normal thyroid gland. Found to affect 4-7% of total population with female to male ratio being 4:1. majority of STN are benign. Benign causes include colloid goiter. and dominant nodule of multi nodular goiter. Incidence of malignancies is around 5- 10%. A systemic approach is needed to evaluate and treat STN.

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.

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.

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