Prediction of thyroid malignancy based on clinical, radiological and biochemical factors with emphasis on serum TSH.

Many patients present to the surgical department with a thyroid nodule. However not all require surgery and only 5-6% of these are malignant. There are many methods to diagnose and predict malignancy in a thyroid nodule. This study throws light on the usefulness of clinical, radiological and TSH estimation and its role in predicting malignancy. There is a definite relationship between higher TSH levels and malignancy. TSH levels could be used as predictor in clinically suspicious malignant thyroid swelling with a benign FNAC report. In such cases where TSH value is high, the FNAC can be relooked to confirm the diagnosis. In addition to TSH, clinical features such as lymphadenopathy, fixity, SNT, USG features such as hypoechoic, calcification, invasion to adjacent structures are also predictors of thyroid malignancy