From diagnosis to treatment: Examining disparities in thyroid nodule evaluation and its impact on patient care

Abstract

Controversy exists regarding the management of thyroid nodules because of conflicting information regarding the excessive occurrence of thyroid nodules, various occurrence of most cancers stated in the ones surgically excised and the frequency of loss of life from thyroid most cancers. The guidelines suggest an algorithm for evaluation of thyroid masses. 1Workup should start with history and physical examination, proceed to laboratory studies, and then to imaging. Even though FNAC is superior to USG, basically USG is used for evaluation of all thyroid masses initially, followed by FNAC. This study was done to know about the disparities between preoperative investigations and postoperative histopathology report of thyroid swelling. Methods: Study was done in 50 patients with thyroid masses which were subjected to FNAC, TFT and USG neck and their results were later correlated with histopathological examination report (HPR) whenever available. Results: Out of 50, 7 patients had disparities between preoperative and postoperative diagnosis, but it was statistically insignificant. Conclusion: FNAC stands at higher level with respect to P value and significance. Despite the fact is that, there are some patients whose preoperative and postoperative diagnoses were different. They either didn't want the first surgery or they want a second one. 2Detecting malignancy preoperatively allows total thyroidectomy in a single operation without the need for frozen section or a second operation for completion of a thyroidectomy if malignancy is found during the initial thyroid lobectomy. Among them, FNAC was more reliable compared to other investigations in diagnosing malignant conditions preoperatively. Both FNAC and USG over diagnosed colloid goitre.