Solitary Thyroid Nodule (STN)
- Definition: A discrete swelling in an otherwise impalpable thyroid
- 3-4% of adult, F:M-4:1
- Risk of malignancy 10-15%
- Condition presenting as STN:
- Dominant nodule of MNG (Toxic nodule)
- Thyroid adenoma
- Cyst
- Carcinoma 10-15% (Children 50%) MALIGNANCYZ
- Colloid goitre (simple nodule)
- Localised type of thyroiditis
STN- Risk factors for carcinoma
- Male > 50, children
- Exposure to radiation (low dose)- Hodgkin’s, ca-breast
- Rapid nodule growth
- Pain, hoarseness, compressive symptoms
- History of MEN 2 (HPT, phaeochromocytoma, MTC)
- Family history of thyroid carcinoma
- Firm, irregular, fixation, LAP (papillary carcinoma)
- Lymphadenopathy
STN- Evaluation
- TFT, serum calcitonin, antibodies
- US: Solid/ cyst / art of MNG/ LAP
- Isotope scan: differentiate toxic nodule vs toxic MNG
- FNAC: colloid nodule, thyroiditis, papillary/MTC/anaplastic ca/ lymphoma. Cannot distinguish follicular adenoma vs carcinoma
Indication for surgery in STN
- Malignant or suspicion of malignancy
- Toxic adenoma
- Pressure symptoms
- Cosmetic