Solitary thyroid nodule: the risk of cancer and the extent of surgical therapy

Objectives: To study the incidence of thyroid malignancy in patients with solitary thyroid nodule presenting to surgical clinics and assessing the extent of the surgical therapy offered. Design: Cross-sectional study. Setting: King Khalid University Hospital, Riyadh, Saudi Arabia. Subjects: The surgical and histological data of 172 patients with solitary thyroid nodules who underwent surgery were reviewed. All patients had clinical evaluation, laboratory and radiological work up and most of them had fine needle aspiration biopsies performed. The extent of surgery and the final histological diagnosis was reviewed. The different surgical options included: lobectomy ± isthmusectomy, subtotal thyroidectomy, near total thyroidectomy and total thyroidectomy. Those patients with solitary thyroid nodules who had non-surgical therapy were not included in the study. Results: Thirteen point nine percent of patients were found to have malignancy on final paraffin section, most of them were papillary type. Fifty nine per cent of patients underwent lobectomy + isthmusectomy. All patients who developed recurrence after surgery had only lobectomy as their initial surgical therapy. Conclusion: The incidence of malignancy in our series is 14% which is comparable to previous reported results. Our patients with thyroid carcinoma who underwent more extensive surgery were better off regarding recurrence. East African Medical Journal Vol.81(9) 2004: 459-46