Amjad Iqbal, Muhammad Ismail, Muhammad Israr, Nisar Ali, Javed Zaman.
Management of solitary thyroid nodule.
J Postgrad Med Inst Jan ;19(1):30-5.

Objective: To evaluate patients presenting with solitary thyroid nodule and to stream line the management policy. Material and Methods: This is a descriptive, hospital based study, done prospectively, comprising of 50 patients, conducted at Saidu Group of Teaching Hospital from Feb. 2001 to March 2003. These patients were first assessed clinically by taking history, physical examination. Relevant investigations such as thyroid function test, radioisotope scans, ultrasound, antibodies 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 on out patients basis. Thyroid surgery ranging from lobectomy and isthmusectomy to near total and total thyroidectomy was performed depending upon age of the 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 1year interval and the results calculated. Results: Most of the patients were female, with female to male ratio of 2.8:1. Majority of the patients presented with swelling in front of the neck. Out of fifty patients, seven responded to non-surgical treatment. One with anaplastic carcinoma, an elderly otherwise unfit patient received radiotherapy and the rest were subjected to various types of surgical procedures. Transient hoarseness and mild to moderate pain in the neck, lasting for a few weeks time was noted postoperatively in some of the patients. We did not have any operative mortality. Conclusion: 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 long 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.


USER COMMENTS

i am salim khan working in medical ward central wing swat saidu sharif hospital.i read the topic , which impressed me too much.i am very happy to see my hospital name on net. thanks ALLAH
Posted by: salimswati on Feb 2006

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