1 / 12

SOLITARY THYROID NODULE

SOLITARY THYROID NODULE. Schwartz’s MANUAL OF SURGERY. 2010. Solitary thyroid nodules are present in approximately 4 percent of the population . Thyroid cancer has a much lower incidence of 40 new cases per1 million.

rea
Download Presentation

SOLITARY THYROID NODULE

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. SOLITARY THYROID NODULE

  2. Schwartz’sMANUAL OFSURGERY 2010

  3. Solitary thyroid nodules are present in approximately 4 percent of the population . • Thyroid cancer has a much lower incidence of 40 new cases per1 million. • Details regarding the nodule :time of onset, change in size, pain, dysphagia, dyspnea, or choking .

  4. A history of hoarseness is worrisome because it may be secondary to malignant involvement of the recurrent laryngeal nerves. • Risk factors for malignancy, such as exposure to ionizing radiation and family history of thyroid and other malignancies .

  5. Nodules that are hard, gritty, or fixed to surrounding structures, such as to the trachea or strap muscles, are more likely to be malignant . • Afine-needle aspiration biopsy is the most important diagnostic test .

  6. Benign (65 percent),suspicious (20 percent), malignant (5 percent), and nondiagnostic (10 percent) . • The incidence of false-positive results is approximately 1 percent and false negative results occur in approximately 3 percent of patients.

  7. The risk of malignancy in this setting is less than 3 percent. • The risk of malignancy in the suspicious cytology is anywhere from 10–20 percent. • FNA biopsy also is less reliable in patients who have a history of head and neck irradiation or a family history of thyroid cancer, because of a higher likelihood of cancer and coexistent benign and malignant lesions.

  8. patient with a nodule is found to be hyperthyroid, the risk of malignancy is approximately 1 percent. • Ultrasound is helpful for detecting nonpalpable thyroid nodules, for differentiating solid from cystic nodules. • CT scan & MRI are unnecessary in the routine evaluation of thyroid tumors except for large, fixed, or substernal lesions .

  9. 123I or 99mTc is rarely necessary, just in “hot” or autonomous thyroid nodules. • Thyroidectomy should be performed if a nodule enlarges on TSH suppression, causes compressive symptoms, or for cosmetic reasons.

  10. patient who has had previous irradiation of the thyroid gland or who has a family history of thyroid cancer. In these patients total or neartotalthyroidectomy is recommended because of the high incidence of thyroid cancer (≥ 40 percent) and decreased reliability of FNA biopsy .

  11. Sabiston Textbook of Surgery 18th ed.

More Related