Diagnosis and Surgical Management of Solitary Thyroid Nodule

Background: Preoperative distinction between benign and malignant in solitary thyroid nodules is important. It helps to avoid unnecessary surgery and its adverse effects, such as hypothyroidism, hypocalcemia, and recurrent nerve injury.

Methods: Descriptive perspective analysed data over a period of 6 years April 2015-April 2021 in Saudi Hospital at hajjah, Yemen. 226 thyroid operations for 207 patients, 135 patients diagnosis as Solitary thyroid nodule and 72 patients as Multi nodular goiter. Patients with a clinically solitary thyroid nodule were included in the study group.

Results: 135 cases of clinically detected STN, 126 female and 9 male patients, between 14-65 years age, median 41 years and mean 39.76 years (94, 41)patients respectively Right side thyroid effect more than Left side, FNAC sensitivity, specificity and accuracy was (61%, 72%, 64%) respectively. Postoperative histopathology reported 100 (74%) patients as having benign thyroid nodules and 35 patients (26%) as having malignant thyroid nodules. Postoperative transient hypocalcemia was observed in 9 patients (7%), and temporary horsnese was observed in 3 patients (2%).

Conclusion: The incidence of malignancy in STN is high. Rapid growth by history and hard fixed nodule by examination and hypoechoic, micro calcification and cervical lymphadenopathy on USG frequently in malignant nodules. Male risk factors for thyroid cancer included age, number and size of nodules. FNAC is more helpful for diagnosing aspiration under USG guidance and reading by experience histopathologists. The type of surgery depends on preoperative evaluation, including history, examination, ultrasound, FNAC result, and intraoperative assessment of the nodule. There are fewer complications of thyroid surgery by experienced surgeons.

Author(s): Burkan Nasr, M Qubati, S Qubati, Abdulhakim Al-Tamimi, Yasser A Rabo, Anwar Aljounaeed, Abdulfatah Al-Tam, Mohmmed Al-Shujaa and Mohmmed Al-Shehari

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