Malignancy In Solitary Thyroid Nodule Research Articles

Malignancy in a Solitary Thyroid Nodule: A Retrospective Histopathological Evaluation.

This study aimed to assess the presence and type of malignancy in patients who underwent thyroid surgery for solitary thyroid nodules. A retrospective review was performed of the case notes of all adult patients with solitary thyroid nodules who underwent thyroid surgery from 1 January 2019 to 31 October 2022. All patients had solitary thyroid nodules identified by ultrasonography. The electronic records of our pathology department were used to determine the pathological diagnosis. Forty-two patients with solitary thyroid nodules underwent thyroid surgery. The mean age at presentation was 39.1 ± 12.6 years, and 76.2% of patients were female. The malignancy rate was 31%. Further histopathological analysis found that malignant solitary thyroid nodules were mostly papillary carcinoma. This study indicates that solitary thyroid nodules should be evaluated thoroughly and treated with a high index of suspicion because they have a high chance (31%) of being malignant.

EVALUATION OF INCIDENCE OF MALIGNANCY IN SOLITARY THYROID NODULE AT A TERTIARY CARE HOSPITAL

Objective: This study aims to identify the incidence of malignancy in solitary nodule thyroid in a tertiary care hospital in Kalaburagi, Karnataka. Methods: This was a prospective non-randomized hospital-based interventional study carried out on 50 patients over a period of 1 y, who presented with clinically palpable solitary thyroid swellings and subsequently underwent surgery for the same at the Department of General surgery, Gulbarga Institute of Medical Sciences, Kalaburagi, Karnataka. Results: Over the total duration of the study period, there were 50 cases of clinically detected solitary thyroid nodule with a high female preponderance. The mean age of the incidence of solitary thyroid nodule was 40.6 y. The incidence of malignancy in solitary thyroid nodule was found to be 18%. Conclusion: It is concluded from the present study that 18% of solitary thyroid nodules are malignant, with female preponderance and a mean age of solitary thyroid nodule is 40.62 y.

A CLINICAL STUDY OF INCIDENCE OF MALIGNANCY IN SOLITARY THYROID NODULE IN A TERTIARY CARE HOSPITAL

Introduction:Thyroid nodules are common entities presenting to the surgical outpatient department. They are defined as A discrete swelling in an otherwise impalpable gland. Incidence of malignancy has been observed to be quite high in solitary thyroid nodules. Thus, they have to be evaluated properly for optimum management. Aim of the study is to identify the incidence of malignancy in solitary nodule thyroid. Materials and Methods:This study was a prospective non-randomized hospital based interventional study carried out on 50 patients who presented clinically with solitary thyroid swellings who thereby underwent surgery for the disease from August 2020 to July 2022 at the Department of General surgery of our institute. Results:There were 50 cases of clinically detected solitary thyroid nodule with female preponderance more than males. The mean age of the incidence of solitary thyroid nodule was 40.6 years. The incidence of malignancy in solitary thyroid nodule was found to be 18%. Conclusions:It is concluded from the present study that 18% of solitary thyroid nodules are malignant, with female preponderance and a mean age of solitary thyroid nodule is 40.62 years.

ROLE OF ULTRASOUND TO DIFFERENTIATE BETWEEN BENIGN AND MALIGNANT THYROID NODULES WITH HISTOPATHOLOGICAL CORRELATION

Background: The only endocrine gland that may be directly examined because to its supercial placement and size is the thyroid gland, which is the largest of all endocrine glands. High resolution real-time gray-scale sonography with the thyroid gland's supercial position enables good visibility and assessment of both its pathologic status and normal structure. The goal was to l Aim: ink histopathology results with sonographic criteria to distinguish between benign and malignant thyroid nodules. From April 2022 to November 2 Materials and Methods: 022, based on criteria for inclusion and exclusion, 50 cases with thyroid nodules were included in the study. Each nodule's sonographic features were identied. After that, the outcomes were contrasted with histopathological diagnosis. 40 Results: benign and 10 malignant solitary thyroid nodules assessed by ultrasound out of 50 total cases were determined, 43 out of 50 instances were benign and 7 were malignant, according to histopathological analysis. To distinguish between benign and malignant etiologies, ultrasound is a relatively safe and accurate investigation with sensitivity of 85.7 % and specicity of 90.7%. In order to distinguish between benign and malignant lesions, USG has proven to possess greater sensitivity. Conclusion: Thyroid nodules were prevalent in women between the ages of 31 and 45. With a sensitivity of 85.7% and a specicity of 90.7%, ultrasound is a relatively safe and accurate test to distinguish between benign and malignant etiologies.

The Role of Neutrophil to Lymphocyte and Platelet to Lymphocyte Ratios in Diagnosing Thyroid Nodule

Background: Thyroid nodule is a common clinical finding and may be associated with a 5%–7% risk for malignancy. Methods for the detection of malignancy had their own drawbacks, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) may give a promising result to solve this dilemma. The Aim of the Study: This study aims to evaluate NLR and PLR as predictors of malignancy in solitary thyroid nodules. Also, to estimate their effect on tumor size, lymph node metastasis, and extrathyroidal extension. Patient and Methods: Prospective cohort study conducted at Major Teaching Hospital over a period of 1 year. Patients with solitary thyroid nodules were included in the study and according to histopathological results divided into two groups (A: Malignant and B: Benign), blood samples were drawn from participants, and measurement of lymphocyte, neutrophil, platelet, NLR, and PLR was done. Results: Both NLR and PLR were higher in cases of malignancy with a cutoff point for NLR >2.9 associated with 84.8% sensitivity (SN) and 71.4% specificity (SP), while PLR >140.15 associated with 87.9% SN and 71.4% SP. High NLR is further associated with larger tumor size. Conclusion: Both NLR and PLR are good predictors of malignancy of thyroid nodules. NLR of more than 2.9 is associated with larger-size tumors.

Clinicopathological study of malignancy in solitary thyroid nodule

Objectives. To study proportion of malignancy in patients with solitary thyroid nodule who had underwent hemi/total thyroidectomy. Methodology. Study design: Cross sectional study. Study setting: Patients in the Out-patient and In-patient Department of General Surgery, Government Medical College, Thiruvananthapuram. Sample size: 150 patients Study Procedure: Data was collected using a structured proforma. An informed consent written in the local language was read out to the study subjects and signature was obtained. All the questions in the proforma were read to the study subjects and responses recorded. Investigation reports and previous medical reports were used for filling relevant parts of the proforma. Analysis: Data collected was entered in excel sheets and analyzed using SPSS software. Results. 150 patients were operated for clinically detected STN. 16 (10.67%) were malignant. Papillary thyroid cancer was the most common type (93.75%). Mean age of patients with malignancy (n = 58) was 39.94 ± 14.83 years. Out of them 12 were females and 4 were male patients (F: M = 3: 1). 134 STNs were benign (23 males and 111 females). Malignant STN was reported in 14.81% males and 9.76% females. No significant correlation between tumour size and the risk of malignancy (P = 0.338). Altered thyroid function status is not a predictive factor for malignancy (P=0.801). FNAC (P=0.002) and USG (P=<0.001) were predictive of malignancy. Complications were more associated with total thyroidectomy (53.57%). Most frequent complication was transient hypocalcemia (15.4%). Hospital stay were more in patients who had underwent total thyroidectomy (P=<0.001). Conclusions. STN has high malignant potential compared to MNG. Preoperative evaluation with thorough history, physical examination, USG and FNAC could diagnose STN as benign or malignant. Strong predictors of malignancy include male gender, micro calcification and cervical lymphadenopathy. Complications are more associated with Total thyroidectomy. Hypocalcemia was the most common complication following thyroid surgery.

Clinical study of prevalence of malignancy in nodular thyroid swelling

Background: Large proportion of thyroid cancers arose from a pre-existing adenoma or from multinodular goiters. Surgical practice of removing thyroid nodule or multiple nodules of thyroid gland has been challenged for surgeons to prevent cancer. Aim of this study is to find out the prevalence of malignancy in solitary thyroid nodule and multi-nodular goitre in relation to age and sex. The aim of the study was to determine the incidence of malignancy in patients who underwent thyroidectomies.Methods: Study of 100 cases of nodular thyroid swelling has been done during the period from November 2017 to November 2019 on inpatients admitted to GEMS Hospital, Srikakulam, and Andhra Pradesh, India. Detail clinical examination, relevant investigations, surgical management and histopathological reports were collected and analyzed using software package for statistical analysis (SPSS 20).Results: Out of 100 patients with thyroid swellings, thyroid malignancies constitute 4%. The occurrence of thyroid cancer was maximum in the 4th decade of life. Female patients outnumbered males with a ratio of 4:0. Relative frequency of malignancy in solitary thyroid nodule was 4.76% and in multi-nodular goitre was 3.03%. Most common histopathological type was papillary carcinoma thyroid (50%); followed by follicular carcinoma thyroid (25%) and medullary carcinoma (25%).Conclusions: The prevalence of thyroid malignancy in the present study is at an earlier age group due to early diagnosis and treatment. The prevalence of thyroid cancer is higher in female when compared to those reported in the literature. The proportion of medullary cancer is more in present study.

Clinical study of solitary nodule of thyroid and role of FNAC in the management of solitary nodule of thyroid

Background: 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. Objectives: Clinical study of solitary nodule of thyroid and role of FNAC in the management of solitary nodule of thyroid. Method: This prospective study includes 70 patients, presenting in KIMS, Koppal who were clinically diagnosed as solitary nodule of thyroid. 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 histo-pathological report appropriate postoperative therapies were administered to all the patients and all the patients were followed up appropriately. Result: 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 1:8.16. 33% of all clinically solitary nodule turned out to be multi-nodular goiter. Incidence of malignancy in solitary thyroid nodule was 10.9%. Male to female ratio in case of malignant nodule was1:5. 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 (67%) followed by follicular carcinoma (33%). Conclusion: USG can be accurately used to detect patients with multinodulary goiter who clinically present as solitary nodule of thyroid. Common causes of solitary nodule of thyroid are MNG, follicular adenoma and adenomatous goiter.

Solitary Thyroid Nodule: Clinical, Sonography and Pathological Evaluation Risk of Malignancy

Aim: To determined risk of increases Incidence of Thyroid cancer in solitary thyroid nodules so Preoperative distinction between benign and malignant in solitary thyroid nodules is important and helps to avoid unnecessary surgery and its adverse effects, such as hypothyroidism, hypocalcemia, and recurrent nerve injury. Methods: Descriptive perspective analyzed data over a period of 6 years April 2015-April 2021 in Saudi Hospital at Hajjah, Yemen. 226 thyroid operations for 207 patients, 135 patient’s 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 solitary thyroid nodules, 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, Fine needle aspiration cytology (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 hoarseness was observed in 3 patients (2%). Conclusion: The incidence of malignancy in solitary thyroid nodules is high. Rapid growth by history and hard fixed nodule by examination and hypoechoic, micro calcification and cervical lymphadenopathy on Thyroid Ultrasound frequently in malignant nodules. Male risk factors for thyroid cancer but age, number and size of nodules not included as risk factor. Fine needle aspiration cytology (FNAC) is more helpful for diagnosing if aspiration under Ultrasound guidance and reading by experience histopathologists. The type of surgery depends on preoperative evaluation, including history, examination, ultrasound, fine needle aspiration cytology (FNAC) result, and intraoperative assessment of the nodule. There are fewer complications of thyroid surgery by experienced surgeons.

Assessment of Accuracy of Fine Needle Aspiration Cytology and Ultrasonography in Relation to Histopathology in Cases of Solitary Thyroid Nodule.

The thyroid gland is an endocrine gland situated in the lower part of front and the sides of the neck. Thyroid nodules are very common with estimated prevalence that ranges from 4% by palpation to 67% by Ultrasonography. The main purpose of our study was to detect cases of thyroid carcinoma preoperatively in patients with solitary thyroid nodules and subsequently advise surgery in these selected patients only, without missing any malignancy. The goal of the investigating modalities used was that they should detect maximum (ideally all) cases of carcinoma and minimize the number of patients who might end up with unnecessary surgery. The present study was to be undertaken for assessment of accuracy of FNAC & USG in relation to Histopathology in cases of solitary thyroid nodule (accuracy in terms of sensitivity, specificity, positive predictive value, negative predictive value). In our series of total 102 pateints, 90 patients were females (88.2%) and 12 cases were males (11.8%). The overall incidence of malignancy in solitary thyroid nodules is 15.68%. In our series the sensitivity and specificity of Fine needle aspiration cytology and Ultrasonography was 81.25% & 98.84% and 75% and 77.91% respectively. The closest method to ideal was fine needle aspiration cytology. However, a combination of techniques, rather than a single technique, give optimum results & avoid unnecessary surgery in a greater number of patients without missing any malignancy.

A study on risk factors for malignancy in solitary thyroid nodules at a tertiary care hospital

Background: Thyroid nodules are a common entity encountered in clinical practice and the prevalence by palpation is only 3-7%, but on ultrasonographic evaluation it is 20-76% with wide variability. Accurate prediction of malignancy with minimal diagnostic modalities and assessing the risk factors in malignancy may help in reducing extensive procedures. The objective of the study is to assess the risk factors associated with development of malignancy in solitary thyroid nodules and to find out the percentage of malignancy among the cases of solitary nodules.Methods: A three year prospective study was conducted at ACSR medical college and all cases diagnosed as solitary thyroid nodules were enrolled and institutional ethical approval was obtained. Socio demographic data, clinical history and ultrasonogram findings were collected and entered in a separate data sheet for analysis. Fine needle aspiration cytology, histopathological examination was done and reported findings were noted. Statistical analysis was done in SPPS version 20 and ‘p’ value <0.05 was considered significant.Results: 128 cases of solitary thyroid nodules (STN) with 41 male and 87 female cases and F:M ratio of 2.13:1 with mean age of 46.6±10.8 years was enrolled. 43.75% were euthyroid, 47.66% were hypothyroid and 8.59% were hyperthyroid on hormonal evaluation. Micro calcification was observed in 50.78%, increased vascularity in 38.28% and irregular margins in 34.38% of cases. Colloid goitre was predominant observation on fine needle aspiration cytology (40.6%) and follicular adenoma (32%) on histopathology.Conclusions: Features of micro calcification, solid echogenicity, and associated lymphadenopathy are associated features with increased risk of malignancy among STN.

Can quantitative diffusion-weighted MR imaging differentiate between different subtypes of benign and malignant solitary thyroid nodules?

BackgroundDiffusion-weighted MR imaging (DWI) is sensitive to changes in the microstructural organization of tissue that may influence water diffusion. It has been utilized in various forms to evaluate head and neck tumors. The apparent diffusion coefficient (ADC) value is a quantitative parameter for distinguishing malignant from benign thyroid nodule. Determination of different pathologic types of the thyroid nodules is crucial for appropriate therapeutic approach. Our point was to assess the utility of apparent diffusion coefficient values in discriminating different subtypes of benign and malignant solitary thyroid nodules using diffusion MRI with pathological correlation.ResultsThis prospective study included 73 patients who had thyroid nodules. The size of the investigated lesions ranged from 0.6 to 3 cm. Most nodules were benign (79.45%), and most of these benign nodules were adenomatous nodules. There was a significant difference in ADC values of benign and malignant thyroid nodules (P 0.0001), with the mean ADC value for the benign group (1.7 ± 0.12 × 10-3) higher than that for malignant nodule (0.71 ± 0.15 × 10). The sensitivity, specificity, and accuracy of ADC in differentiating between benign and malignant thyroid nodules were 97.5, 94.4, and 99.2%, respectively. We noticed a significant overlap in the ADC value of pathological subtypes and upon reviewing the pathological results, we found insignificant differences in the ADC values of the various subtypes of malignant and benign nodules, with P value ranging from 0.054 to 0.062 between different pathological subtypes. A significant difference was only noted between non-complicated cysts and solid nodules P 0.0001. In our series, an ADC value of 0.92 × 10-3 mm2/s or less could be used as an indicator of malignancy, with a sensitivity of 97.5%, a specificity of 94.4%, and an accuracy of 99.2%.ConclusionDiffusion MRI including ADC values are helpful in differentiation between benign and malignant thyroid nodules but not helpful in differentiating between different subtypes of benign and malignant nodules.

Proportion of malignancy in solitary thyroid nodule

Proportion of malignancy in solitary thyroid nodule

Relation between the size and incidence of malignancy in solitary thyroid nodule

Relation between the size and incidence of malignancy in solitary thyroid nodule

A Clinicopathological Study of Solitary Thyroid Nodule

Introduction:Common presentation of thyroid disorders is solitary nodule. A discrete swelling in an otherwise impalpable gland is termed as solitary nodule of thyroid. The majority of solitary thyroid nodules are benign. The incidence of malignancy is 10-20%, being more common in females with a mean age of 35 years.The object of the study was to identify the incidence of malignancy in solitary nodule thyroid which emphasizes on the early diagnosis and adequate treatment.
 Materials and Methods: The study was carried out in the department of ENT and Head-Neck Surgery of Rangpur Medical College Hospital, Rangpur and Shaheed Ziaur Rahman Medical College Hospital, Boruga in 50 patients with solitary thyroid nodule from July 2013 to June 2015.
 Results: The solitary thyroid nodules were seen in 1.76% of surgical admissions. The mean age of the incidence of solitary thyroid nodule is 35 years. The incidence of malignancy in solitary thyroid nodule is 18.51%. The solitary thyroid nodules were frequent in females than males in the ratio of 6.71:1.
 Conclusion: It is concluded from the present study that a remarkable proportion 10% of solitary thyroid nodules was malignant with females preponderance which emphasizes on the early diagnosis and adequate treatment.
 Medicine Today 2019 Vol.31(2): 85-88

Clinical Study of Solitary Nodule of Thyroid at Tertiary Health Centre

Introduction: 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. Material and Methods: Data collection by meticulous history taking and clinical examination, appropriate laboratory and radiological investigations, operative findings, histopathological report and follow-up of cases. Results: Study was conducted with 35 patients. The peak incidence of solitary thyroid nodule was observed in 3rd to 4th decade with four times more common in females as compared to male. The common causes of solitary thyroid nodule were colloid goitre (31.4%), Multinodular goitre (20%) and adenomatous goiter (17.1%), 94% of cases presented with euthyroid state. Incidence of malignancy in solitary thyroid nodule was 23%. The most common cause of malignancy was papillary carcinoma (14.3%). Conclusion: Solitary thyroid nodule is more common in 3rd to 4th decades. Solitary thyroid nodule is more common in females. Most of the patients presenting with solitary thyroid nodule 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 thyroid nodule. Common causes of solitary thyroid nodule are colloid goitre, MNG, and adenomatous goiter. The most common cause of malignancy in solitary thyroid nodule is papillary carcinoma followed by follicular carcinoma.

Role of Midkine in Predicting Malignancy in Patient with Solitary Thyroid Nodule

Background: Solitary thyroid nodules are a common clinical problem. None of sonographic features is sufficient to discard or detect malignancy efficiently. Midkine is a novel heparin-binding growth factor, plays critical roles in carcinogenesis. In this study, we aimed to evaluate serum midkine levels in patients with solitary thyroid nodules to predict malignancy.
 Methods: A total of 100 patients who had solitary thyroid nodules were enrolled in the study. Serum midkine levels were measured. Fine needle aspiration cytology was done to all nodules (25 suspicious/ malignant and 75 benign).
 Results: Serum midkine levels were significantly higher in patients who had nodules with the following sonographic features; hypoechoic nodules compared to isoechoic and hyperechoic nodules (P=0.024), nodules with microcalcification compared to nodules with macrocalcification or without calcification (P = 0.011), nodules with irregular borders compared to nodules with regular borders (P = 0.014) and nodules more than 2 cm in length than shorter ones (P = 0.011). Serum midkine levels were also higher in nodules with absent halo compared to those with clear halo but with no significant difference (P = 0.660). Also, levels of serum medikine were significantly higher in suspicious/ malignant nodules than in benign nodules (P < 0.001).
 Conclusion: Serum midkine can predict malignancy in solitary thyroid nodule and also well correlated with sonographic features of thyroid nodules. We suggest that midkine levels may serve as a novel biochemarker in association with sonographic features in evaluation of solitary thyroid nodules.

Diagnostic Efficacy of Ultrasonography and Fine-needle Aspiration Cytology in Correlation with Histopathology in Euthyroid Patients Having Solitary Thyroid Nodule

Objective: In patients with solitary thyroid nodules, first approach is to confirm whether the nodule is benign or malignant. Commonly available investigations used in the evaluation include thyroid hormone assays, fine needle aspiration cytology (FNAC) and ultrasonography (USG) among others. These procedures are not without drawbacks. The present study was undertaken to compare the diagnostic efficacy of USG and FNAC in correlation with histopathology in euthyroid patients having solitary thyroid nodule. Study Design: A prospective study was carried out on 48 euthyroid cases of solitary thyroid nodule attending the Department of ENT, SMS Medical College & Hospital, Jaipur, during the period of March 2016 to November 2017. All patients underwent ultrasonography and fine-needle aspiration cytology. The results of FNAC and USG were correlated with post surgical histopathogical examination (HPE) of the specimens to evaluate their sensitivity and specificity by statistical methods. Results: Ultrasound was 87.5% sensitive & 92.50% specific in the detection of malignancy in solitary thyroid nodules while the fine needle aspiration cytology had a sensitivity of 87.50% & specificity of 100% in the same regard. Conclusion: It was found that FNAC is a safe, reliable and cost effective diagnostic modality with a high sensitivity and specificity and is the single best investigation for preoperative evaluation of solitary thyroid nodule to differentiate between benign and malignancy nodules.

Malignancy in Solitary Thyroid Nodules: A Study on Incidence & Evaluation of Risk

Malignancy in Solitary Thyroid Nodules: A Study on Incidence & Evaluation of Risk

A study of prevalence pattern of malignancy in solitary thyroid nodule at tertiary health care centre

A study of prevalence pattern of malignancy in solitary thyroid nodule at tertiary health care centre