ABSTRACT
To determine the diagnostic potential and cost-effectiveness of various diagnostic methods and effectiveness of various treatment methods for the management of cold thyroid nodules Prospective surgical study with follow up. Surgical outdoor and surgical unit-iv Nishtar Hospital Multan. Random selection of 30 patients of cold thyroid nodule regardless of age, sex and domicile. Of the 30 patients on FNAC 5 patients [16.66%] had cystic nodules, 18 patients [60%] had benign solid nodules. 2 patients [6.66%] had malignant disease while 5 patients [16 66%] had cytology Indeterminate or suspicious for malignancy Out of 5 patients with cystic nodules, who were aspirated-2 patients [40%] had no recurrence while 2 patients who had blood stained aspirate had lobectomy. 5 patients out of 18 [27,77%] were given LT4 therapy. 2 patients out of these 5 [40%] had more than 50% decrease in the size of the nodule while 1 patient had no benefit. 2 patients did not continue the medical treatment and opted for surgery. The fine needle aspiration cytology proved to be a reliable method for the preoperative diagnosis of cold thyroid nodule and better planning of their management Routine use of USG and thyroid scan was not helpful to distinguish between benign and malignant cold nodules. A need was felt about the selective policy for the surgical excision of cold throid nodule