Management of solitary thyroid nodule: new update

ABSTRACT

The study was done on [56] patients with clinically apparent Solitary Thyroid Nodule [S.T.N]. They were treated in Mansoura Endocrine Surgery Unit [M.E.S.U] during the period from January 2005 -January 2006 inclusive. All our patients were presented by palpable single nodule in the thyroid gland. Patients with malignant nodule were mainly presented by rapid recent increase in the size of the nodule and some presented with early hoarseness of voice. Those with toxic nodule were presented with thyrotoxicosis and those with simple nodule were presented by accidentally discovered thyroid swelling. All patients were submitted to careful history taking and clinical examination. Different methods of investigations were done that included measurement of thyroid hormones, neck ultrasound, Computerized Tomography [C.T], Magnetic Resonance Imaging [M.R.I] in certain cases when needed and thyroid scan using Technetium ninety nine [Tc99]. Histopathological examination was done using Fine Needle Aspiration Biopsy [FNAB], truant needle biopsy or frozen section. According to the result of the pathology whether a] Malignant [Papillary, Follicular, Medullary] b] Simple [benign] c] Toxic, adequate treatment was done that varies in every case ranging from total lobectomy in benign lesion up to total thyroidectomy and block dissection or cherry picking in medullary or papillary cancer respectively. S.T.N may become an easier surgical problem after following a specific proposed protocol in management