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Occurrence of malignancy in solitary thyroid nodule at tertiary care centre

Author: 
Satyanarayan, V. and Vishwanath Kuri
Subject Area: 
Health Sciences
Abstract: 

Background: True solitary nodule occurs in 4-8% of the population and in autopsy it is seen in 50% of cases. The prevalence of thyroid nodule increases with age and women have a higher prevalence than men. Seventy percentage of solitary thyroid nodules are benign, indeterminate15%, malignant 5%, nondiagnostic in 15%. Increasing numbers of nodules are being detected serendipitously because of rising use of imaging technique. Solitary thyroid nodules being so prevalent in the general population, it is important to have clear strategy of assessing nodules and determining which will require surgery or can be managed conservatively. Objectives of the study: 1. Primary aim in investigating thyroid nodules is to exclude possibility of malignancy.2. Analyzing the efficacy of clinical, biochemical, radiological and cytological evaluation of nodules. 3. Evaluating the management of solitary thyroid nodule, Identifying malignant nodule requiring surgery and its incidence and its outcome. Methods: The study was conducted in ESI Model Hospital from January 2015 to June 2016. Patients satisfying inclusion criteria were enrolled. All the patients with solitary nodule thyroid are evaluated with thorough clinical examination, cytological, radiological and laboratory investigations. Appropriate thyroid surgery was performed and analyzed for histopathological examinations results. Results : The commonest presentation of solitary thyroid nodule was asymptomatic swelling in front of the neck. The peak incidence of solitary nodule thyroid observed in 3rd to 5th decade, constituting 66.3% of the cases studied, Female predominance over male with ratio of 18:1 noted in occurrence of SNT. The common causes of solitary nodule was colloid goitre (50%), follicular adenoma (25%), adenomatous goiter (3%). Euthyroid state was noted in 95% of the cases. Incidence of malignancy in solitary thyroid nodule was 14.3%. The most common cause of malignancy was papillary carcinoma (72%) followed by follicular carcinoma (28%). Conclusion: Solitary nodule of thyroid are more common among females and peak incidence in 3rd to 5th decade. Most of the patients presenting with solitary nodule of thyroid 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 nodule of thyroid. Incidence of malignancy in male patients presenting with solitary nodule of thyroid is more when compared to female. The most common cause of malignancy in solitary nodule is papillary carcinoma followed by follicular carcinoma.

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