Management of Solitary Thyroid Nodule

Abstract

To evaluate patients presenting with solitary thyroid nodule and to stream line the management policy. This is a descriptive, hospital based study, done prospectively, comprising of 50 patients, conducted at Saidu hospital Swat from February 2001 to March 2003. These patients were first assessed clinically by taking history, physical examination. Relevant investigations such as thyroid function test, radiosotope above all fine needle aspiration estimation, radiological evaluation i.e. x-ray chest and neck and above all fine needle aspiration cytology were done in these patients. After making a diagnosis the patients were categorized into two groups for the purpose of final treatment. those who required surgery were admitted and those who needed medical treatment were treated. those who required surgery were admitted and those who needed medical treatment were treated on out patients basis. Thyroid surgery ranging from lobectomy and isthmusectomy to near total and total thyroidectomy was perforemed depending upon age of th patient size of the swelling and histological/cytological nature of the nodule. all the patients were regularly followed post operatively at 3 months, 6 months and 1 year interval and the results calculated. Although most of the nodules (about 90%) evaluated turned out to be benign in nature but the fear of cancer, the anxiety associated with and the likely outcome of treatment demands a thorough work up of the condition and a logn term follow up. Apart from medical treatment, aspiration of benign purely cystic nodules and surgical excision plays a major role in the alleviation of the disease.