Author(s): Ramalakshmi Venkateswaran1, Kannan Ross2, Kenny Robert3, Kadhirvel4
Solitary nodule of thyroid has increased in incidence in the present day as compared to two decades before. Because of possibility of malignancy, some clinicians especially those in surgical subspecialties recommended that all nodules have to be removed. This study aimed to determine the proportion of solitary nodule of thyroid in general population and in relation to age and sex, the proportion of solitary nodule of thyroid turning out to be multinodular goiter, the proportion of euthyroid, hyperthyroid or hypothyroid states in patients presenting with solitary nodule of thyroid to study the role of FNAC in the management of solitary nodule of thyroid and to determine the incidence of neoplastic and nonneoplastic conditions as a cause of solitary nodule of thyroid in Government Royapettah Hospital, Chennai.
MATERIALS AND METHODS
This prospective study includes 50 patients presenting in Government Royapettah Hospital, Chennai, who were clinically diagnosed as solitary nodule of thyroid between November 2014 to September 2015. All patients were admitted and were subjected to thyroid profile, USG and FNAC. All patients were operated appropriately depending on the FNAC report. Histopathological examination of the operated specimen was done for all the patients. Depending on the histopathological report, appropriate postoperative therapies were administered to all the patients and all the patients were followed up appropriately.
Commonest presentation of solitary thyroid nodule was asymptomatic. The peak incidence of solitary nodule was observed in 3rd to 5th decade constituting 60% of the cases studied. Females predominated in number over males in occurrence of solitary nodule in ratio of 1:5.25. 33% of all clinically solitary nodule turned out to be multinodular goiter. The common causes of solitary nodule was MNG (26%), follicular adenoma (24%), adenomatous goiter (24%). 95% of cases presented with euthyroid state. Incidence of malignancy in solitary thyroid nodule was 18%. Male-to-female ratio in case of malignant nodule was 1:5. Incidence of carcinoma in males presenting as solitary nodule was higher (16.67%) compared to that of females (10.20%). The most common cause of malignancy was papillary carcinoma (55%) followed by follicular carcinoma (45%).
Solitary nodule of thyroid is more common in 3rd to 5th decades. Solitary nodule of thyroid are more common in females. 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. Common causes of solitary nodule of thyroid are MNG, follicular adenoma and adenomatous goiter. 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.