Abstract
Solitary nodule of thyroid can present in wide spectrum ranging from true solitary nodule or dominant nodule or ectopic thyroid tissue and have a varied presentation and diagnostic and therapeutic modalities differ from patient to patient. The aim of the study is to review the incidence data, observe clinical presentation, rate of malignant nodules, confirm role of surgery as the therapeutic tool and role of histopathology in managing the patients.
Materials and Methods: A prospective study of solitary nodule of thyroid patients presenting in Department of General Surgery at Rajah Muthiah Medical College, Chidambaram, Tamilnadu, between period of 3 yrs between June2015 to June2018.
Results: Out of 112 patients who presented as goitre 22 patients was found to have SNG of these 15 cases were SNG and 7 cases had multinodular goitre. In true SNG group 2 patients had malignancy of these 12 patients was treated with Total thyroidectomy, 6 patients with hemithyroidectomy and 2 patients, with small nodule is treated conservatively and 2 patients not willing for any treatment.
Conclusion: In this study 11.4% of SNT is found to be malignant and males are more prone for malignancy and more common among extremes of age. FNAC is a gold standard investigation and accuracy of diagnosing SNT is 94% Hemithyroidectomy acts as diagnostic method as well as minimal and therapeutic procedure in SNT. A selective surgical policy should be practised to resect SNT.
Keywords: Solitary nodule, Thyroid nodule, Hemithyroidectomy.
References
- Bailey and love – 27th edition pg 707-733
- Sabiston text book of surgery – south Asian edition (1stedition)
- Schwartz 10 th edition pg 1611 – 1680
- Grants atlas of anatomy.
- LA. Earnhardt. Rc, Dum JT et al : Pre Op evaluation and Predictive value of FNA and Frozen section of thyroid nodules J.Am. Coll surgery 187; 494-502, 1998.
- Braveman LE: Iodine and the Thyroid : 33 years of study. Thyroid 4: 351,1994
- Brent GA : the molecular basis of thyroid hormone action. N.Engl.J.Med.331: 847, 1994.
- Burch HB : Evaluation and management of STN : Endocrinol. Metab. Clini. north. am 24, 603-709, 2000.
- Burman KD Ringel MD Wartotsky L Unusual types of Thyroid Neoplasm Endocrinol Metabol. Clin North Am 25 49-68 1998
- P. Medical and Surgical Management of Endemic Goitre. In Clart OH Duh. Qy (eds) Text book of Endocrinology Philadelphia, WB Saunders 1997, p. 15-21.
- Chopra Nature Source and Relative Significance of Circulating Thyroid Hormone In Braverman LE Utiger (eds) Werner and Ing Bar's the Thyroid,, 7t Ed Philadelphia, Lippincott 1996, pp. 111-124.
- Delbridge LW Thyroid Physiology In Clark OH, DUH Qy (Eds) Textbook of Endocrine Surgery. Philadephia W.B. Saunders, Harada T. Katagiri MItok: Hyperthyroidism, Grave dineane and Henry JF. Surgical Anatomy and embryology of Thyroid and p.3-7.
- Toxic Nodular Goitre. In Clark OH, Duqy, pp. 47-53.
- Parathyroid glands and Recurrent and Ext. Laryngeal Nerve Hermur AR Huysmans T.H.E. Treatment of Benign Nodular Lindquist's. Cabin C, Smeds S. The Superior Laryngeal N in Mezzafori EL. Management of SNT, N. Engl. J. Med. 328 553 Sabel MS Staren ED Gianankakis ZM et al Use of FNA Biopsy Involvement, p. 8-14 .
- Thyroid Disease, N Engl J. Med. 338: 143814461999.
- Thyroid Surgery 102: 99920000.
- Woeber KA: Cost Effective Evaluation of Patient with a Thyroid Nodule Surg. Clinic North Amer. 75: 3573632001.
Corresponding Author
Dr R.Ashwin Muthukumar
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