Immunohistochemical analysis of cell block specimens of colloid nodular goiter 12 cases with CK19 showed absent expression in 11 out of 12 cases Cell biology and flow cytometry. If adenoma is diagnosed, only thyroxin therapy for suppression is used. All the patients reported as papillary and follicular carcinoma in HPE, were advised to undergo I whole body scan. The minimally invasive endoscopic thyroidectomy approaches provide a superior cosmetic result when compared to conventional thyroidectomy and results in a quicker return to normal activity.
The method of solitary thyroid nodule management depends chiefly on the scheme used in the diagnosis and treatment. Clinical examination including determination of presence or absence of toxic manifestations and enlarged cervical lymph nodes was done. Hemostasis, safeguarding of the recurrent laryngeal nerve, parathyroid, and other vital structures was taken care of during the dissection. In other malignant lesions, total or near total thyroidectomy is performed with adjuvant treatment according to the type of malignancy, except in lymphoma whose response to chemotherapy and external radiation give good results. But in cases of carcinoma completion thyroidectomy with adjuvant treatment in the form of radioactive iodine and suppressive therapy.
The ADC value is a new promising non-invasive approach used for differentiating malignant from benign solitary thyroid nodules. Metastatic deposits in the lymph nodes were seen in 13 patients of the total 33 patients who had undergone lymph node dissection.
During the study period, patients were operated for various thyroid diseases. Jodule function test and fine-needle aspiration cytology Thyroid function test was done in all patients. The sensitivity of thyroid FNAC in detection of neoplastic lesions was Solid echogenicity, micro calcification and cervical lymphadenopathy on USG were seen more frequently in malignant nodules.
At present, FNAC has replaced other methods, and became the first and the routine method which must be used in diagnosis of solitary thyroid nodule. Hence, we conclude that clinically detected solitary nodules should be treated with high degree of suspicion and patients should be evaluated further with USG and Nodulee.
They should be characterized properly for optimum management. Total thyroidectomy is done for patients showing malignant criteria detected by either cytological examination or flow cytometric study. Central node dissection was done in all malignant cases with USG showing lymph node enlargement and also in cases with intra operative enlarged nodes. In these ten patients frozen or paraffin section was reported as malignant.
Two patients had neuropraxia and improved afterward, in one patient there was unilateral accidental injury and in the other patient, the recurrent laryngeal nerve had to be sacrificed due to tumor infiltration. Contemporary Management of Solitary Thyroid Nodule.
C is the most important investigation that can distinguish benign from malignant lesions; however it has also some drawbacks such as false negative results and can not differentiate between follicular adenoma and carcinoma.
Immunohistochemical analysis of cell block specimens of colloid nodular goiter 12 cases with CK19 showed absent expression in 11 out of 12 cases The patients and their relatives gave consent to use the information for publication purpose. When FNAC report was malignant, nodu,e thyroidectomy was done. How to cite item. For each thyroid nodule, gray-scale and color Doppler US are used to evaluate the US features, which include size, echogenicity hypoechoic or hyperechoicand composition cystic, solid, or mixedas well as presence or absence of coarse or fine calcifications, a halo, irregular margins, and internal blood flow.
The adenomatous colloid nodules are either observed or suppressed nodulf thyroxin, also surgery is recommended if the nodule grows; for the exclusion of malignancy. Out of them 38 were females nofule 20 were male patients M: In all other cases, hemi thyroidectomy was done and subsequent plan was decided based on conclusive frozen or paraffin section report.
Solitary thyroid nodules do have a high solitar of harboring a malignancy.
The present study was based on the review of case records of all patients who were operated for STN. It also may be used for reduction of the volume of neoplastic tissue prior to external radiation therapy or chemotherapy of local or distant recurrences of thyroid carcinoma that are not amenable to surgical or radioiodine treatments. DNA flow cytometry plays an important role in the diagnosis of thyroid nodules by combining the histogram and the results of FNAB which is of great value in the determination of the type of surgery required.
Malignancy in solitary thyroid nodule: A clinicoradiopathological evaluation
Sclerotherapy by tetracycline or ethanol injection is another promising method of treatment of the thyroid cyst. Immunohistochemistry of thyroid fine needle aspiration cytology.
Familial follicular cell tumors: Thyroid nodule refers to a distinct lesion within the thyroid gland that is palpably or radiologically distinct from the surrounding thyroid parenchyma. The methods of solitary nodule management depends chiefly on the scheme used in the diagnosis and treatment.
Author: Milad Shaker,Hany/ Title: UPDATE IN MANAGEMENT OF THE SOLITARY THYROID NODULE
Although conventional open silitary can be performed with few complications, this approach leaves a visible scar on the anterior surface of the neck in a cosmetically unfavorable location. The result of our study shows that the incidence of malignancy in STNs is indeed high. It helps to avoid unnecessary extensive surgery and potential surgery related adverse effects, such as hypothyroidism, hypocalcemia, and recurrent laryngeal nerve injury.