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Year : 2019  |  Volume : 38  |  Issue : 3  |  Page : 411-417

Prospective study evaluating malignancy in solitary thyroid nodule

1 Department of Surgery, Ain Shams University, Cairo, Egypt
2 Department of Surgery, Helwan University, Helwan, Egypt

Correspondence Address:
Wael Omar
Department of Surgery, Helwan University, Helwan
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ejs.ejs_8_19

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Objective The aim of this study was the preoperative evaluation of patients with solitary thyroid nodules (STNs) for the presence of malignancy to avoid unnecessary total thyroidectomy. Patients and methods A total of 83 patients with STNs who underwent hemithyroidectomy, total thyroidectomy, and total thyroidectomy with modified neck dissection in Ain Shams University Hospitals and Helwan University Hospital between September 2016 and December 2017 were evaluated. Parameters including demographics, ultrasonographic, and pathological data were analyzed. Results After evaluation of the final pathology, results showed that malignancy was found in 33/83 (39.8%) patients. A total of 24 (72.7%) of these lesions were papillary carcinoma. Multinodular goiter accounted for 90% of all benign cases. Of 19 malignant cases, 14 (73.7%) were males, whereas of 64 benign cases, 45 (70.3%) were female patients. Nodule echogenicity, nodule calcification, nodule vascularity, nodule shape, and nodule margins were found to have significant prediction for malignancy. Among these factors, increased vascularity and irregular nodule margins were the most important factors. Nodule size did not affect the risk of malignancy. Moreover, lymph node characteristics were found to have significant prediction for malignancy. The FNA results of BII-V reports showed that 17.2% of patients with STN nodule had false negative results. Conclusion Multivariate analysis revealed that in STN, the highest malignancy predictor was the ‘No halo and irregular Margin’ in ultrasound, and that microcalcifications, hypoechoic, and taller nodules were highly suspicious factors for malignancy.

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