CLINICAL EVALUATION AND MANAGEMENT OF SOLITARY NODULE OF
THYROID IN EUTHYROID PATIENTS
Authors: Venkateswarulu M. , Sai Datta* A. , Rajitha Rajitha , Renuka Renuka , Anand Anand , Ravindra Ravindra , Deepak Deepak 
Published: November 2019

BACKGROUND: Solitary nodules of the thyroid have been the area of focus in research since Warren
Colein 1949. It is an area of research with much potential because of its diverse clinicalpresentation and
its wide-ranging etiology and often the risk of malignancy. But the studiesassessing the prevalence and clinical prole of
solitary thyroid nodules are relatively scarcefrom India. Hence the current study was conducted with the objective of
determining theprevalence of solitary nodule of thyroid in general Population and to determine the proportion of a solitary
nodule of thyroid turning out to be multinodular goitre on subsequentevaluation. The study has also assessed the role of FNAC
in the management of solitarynodule of the thyroid and estimatedincidence of carcinoma as a cause of solitary Noduleof the
thyroid to determine the underlying cause of Solitary nodule of thyroid (SNT) by theHPE.
MATERIALS & METHODS:This study was a prospective study conducted in the Department of General surgery inKATURI
MEDICAL COLLEGE fromNovember 2016 to May 2018 for a period of 1.5years.The study population included Solitary Nodule
of Thyroid admitted to theDepartment of General surgery at Katuri medical collegewere considered as thestudy population.
The prevalence was computed against all the OPD attendees in thedened study period. The ndings of ultrasonography,
FNAC and HPE were comparedusing cross tabulation. Since the study did not attempt to test any hypothesis, No statisticaltest
of signicance was used. IBM SPSS statistical software version 21 was used for data/analysis.
RESULTS: During the study period, the total number of subjects attending the Outpatient departmentwere 6485.Among all the
outpatient attendees, the prevalence of solitary thyroid nodulewas 1.23% with 95% CI ranging from 0.96% to 1.5%.Out of 80
clinically diagnosed solitarythyroid nodule cases multi nodular goitrewas found in 7 (8.8%) subjects on subsequentevaluation.
In USG, 51.3% had Hyper Echogenic Nodule while 23.8% had MixedEchogenic Nodule. In 8.8%, the nodule turned out to be a
part of Multi Nodular Goiter while7.5% had Suspicious Multi Nodular Goiter. In FNAC, 86.2% of the nodules were benign
onFNAC. The majority (32.50%) were Benign Colloid Nodules. 26% were colloid nodules inFNAC. 13.8% of the nodules were
malignant in FNAC. Papillary thyroid carcinoma wasseen in 12.5% in FNCAC. In HPE, the majority (78.5%) were benign
nodules. Only 21.5%were malignant. In HPE, 32.5% were a benign follicular adenoma. The proportion of Colloid Nodule was
31.3%, and nodular goitre was 5%. The proportion of Papillary Thyroid Carcinoma, Hashimoto's thyroiditis, Well-Differentiated
PTC, Anaplastic ca. of Thyroid was 13.80%, 3.80%, 2.50% and 1.3% respectively.
CONCLUSIONS: The current study had assessed the burden and clinic pathologicprole of solitary thyroid
nodulecases. The study ndings is an important addition to the existing evidence and guide the clinicians at various levels in
evidence based evaluation and management of the patients with solitary thyroid nodule.