MALIGNANCY IN SOLITARY THYROID NODULE

Abstract

Objective:

To find out the relative frequency of the malignancy in cold solitary thyroid nodules with other solitary thyroid nodules.

Material & Methods:

One hundred patients with clinically and Ultrasonographically diagnosed solitary thyroid nodules in the Dept. of General Surgery and Otolaryngology – Head & Neck Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka were included in this study from January 2011 to December 2012. These patients underwent thyroid scan. Surgery ranging from lobectomy to total thyroidectomy was done based on the FNAC report. The surgical specimens were subjected to histopathological examination, the reports of which were tallied with the thyroid scan and ultrasound findings.

Results:

Out of them, 52 percent of patients were in the third and fourth decades of life and 26 percent were in the second decade of life. Females were more affected than males, and female: male ratio was 2.1:1. Solitary thyroid nodule involved right lobe of thyroid in 60% and the left lobe in 32% patients. The thyroid scan revealed cold nodules in 72%, warm nodule in 25% and hot nodule in 3% patients. 60% of the nodules were solid, 28% cystic and mixed in the rest on ultrasonography. On histopathology, 56 percent were colloid nodule, 28 percent were adenoma and 16 percent were carcinoma. Among the 16 percent malignant patients, majority of the patients had their age between 21-48 years. 20.83% (15/71) of the cold nodules on histopathological examination were malignant while 3.57%(1/28) of the other nodules were malignant. The difference between the two groups was statistically significant.

Conclusion:

Solitary thyroid nodules carry more risk of being malignant, particularly if the patient is young and if the nodule is radio- isotopically cold.

Keywords: Carcinoma, Solitary Thyroid Nodule