Malignancy in solitary thyroid nodule: A clinicoradiopathological evaluation

Abstract

Background:Thyroid nodules are common. They can be either benign or malignant. Solitary thyroid nodules (STN) have a high likelihood of being malignant. They should be characterized properly for optimum management.Materials and Methods:In this study, we have analyzed our departmental data over a period of 5 years. All the patients who presented to the outpatient department with a clinically detected STN were included in the study group. Our approach was individualized. Preoperative ultrasonography (USG) and fine-needle aspiration cytology were planned in all these patients. Hemi thyroidectomy and total thyroidectomy with and without neck dissection were performed wherever appropriate.Results:There were 162 cases of clinically detected STN. USG findings were available in 146 cases. Postoperative histopathology was reported as malignant in 58 cases. Malignant STN was more likely in males. Ultrasonographically detected solid STN were more prone for malignancy as compared to multinodular goiter (P = 0.000) Presence of micro calcification and cervical lymphadenopathy were more commonly noted in malignant thyroid swellings.Conclusion:Solitary thyroid nodules do have a high likelihood of harboring a malignancy. Solid echogenicity, micro calcification and cervical lymphadenopathy on USG were seen more frequently in malignant nodules.

Clinical and Histopathological Profile of Patient With Solitary Thyroid Nodule in Tertiary Care Hospital in South India

“…Out of four malignancies that were confirmed by histopathology, two cases were correctly reported by FNAC and the remaining two cases were reported as suspicious. A study done by Jena et al 11 reported that fine-needle aspiration cytology done before the surgery on 146 patients, the findings were nodular goitre in 62 (42.5%), follicular neoplasm in 55 (37.7%), papillary carcinoma in 25 (17.1%), Hashimoto thyroiditis in two (1.4%), toxic nodule in one (0.7%) and medullary carcinoma in one (0.7%) patient.…”

“…8,9 The occurrence of malignancy is more in solitary thyroid nodules compared to multinodular goitre. 10,11 This increase in incidence is due to identification through the use of ultrasound examinations and the emphasis on early detection of cancer over the past three decades. 12 The occurrence of solitary thyroid nodule is a common entity.…”

Thyroid malignancy risk in different clinical thyroid diseases

“…In a study of 300 patients, 46.2% of solitary thyroid nodules were malignant compared to 22.5% of MNG (7,8). However, this was not the case in several other studies, which reported no difference in cancer prevalence between patients with solitary nodules and those with MNG (9,10,16).…”

Papillary Carcinoma in Thyroglossal Cyst: an Unusual Case

“…FNAC is considered the most reliable method for the detection of malignancy in midline neck masses prior to surgery [6]. Since a majority of lesions are cystic in nature, FNAC of the mural nodule under ultrasound guidance can improve the diagnostic accuracy by reducing the false-negative results [2,7,8].…”