Thyroid nodules: Does the suspicion for malignancy really justify the increased thyroidectomy rates?

The Canadian Pediatric Thyroid Nodule Study: an evaluation of current management practices

“…Fifty-seven patients underwent a primary total thyroidectomy, of whom 14 had determinate cytology on the preoperative FNAC to help guide the choice of operative procedure. The other indications for primary total thyroidectomy included a family history of MEN/MTC (15) and complications related to the medical management of Graves' disease (8). The remaining patients underwent total thyroidectomy at the discretion of the surgeon.…”

“…Fine-needle aspiration cytology has been shown in several studies to have significant utility in preventing total thyroidectomy in adult patients with thyroid nodules [8]. Fine-needle aspiration cytology has been advocated in children as well, but not necessarily for these same reasons [9].…”

Comparative Study of Solidary Nodules of Thryoid in Adults in Tertiary Care Teaching Hospital

“…The anterior jugular veins are identified and divided Total thyroidectomy involves division of all thyroid tissue between the entrance of the recurrent laryngeal nerves bilaterally at the ligament of Berry, and it results in complete removal of all visible thyroid tissue [9,21] Near-total thyroidectomy involves complete dissection on one side while leaving a remnant of thyroid tissue laterally on the contralateral side, which incorporates the parathyroids. Subtotal thyroidectomy leaves a rim of thyroid tissue bilaterally to ensure parathyroid viability and avoid entrance of the recurrent laryngeal nerves into the larynx In three suspected follicular neoplasms only one patient confirmed positive in biopsy.…”

Hürthle Cell Neoplasms of Thyroid in South-Western Region of Saudi Arabia

“…5 It has been proposed in many reports 11,3 that surgical resection should be applied in cases where FNAC categorises the thyroid nodule as a dominant Hürthle cell neoplasm for final diagnosis. In our series FNAC was diagnostic of Hürthle cell neoplasm in two cases, Hürthle cell lesion in one case, and inconclusive in one case, while it was reported as benign in the remaining cases.…”

“…Presence of predominantly solid nodule with ill-defined outlines, hypoechogenicity and increased intra-nodular vascularity are ultrasonographic features, suggestive of malignancy. 11 The role of ultrasound is further complicated if the patient has a multinodular goiter in one or both lobes, as the differential diagnosis will include also hyperplastic dominant nodule. Multinodular goiter is relatively common in our region; 16 therefore, preoperative ultrasonography was not helpful in most cases of our series.…”