Malignancy in solitary solid cold thyroid nodule.

Area of Science:

• Endocrinology
• Oncology
• Diagnostic Imaging

Background:

• Solitary thyroid nodules are common, with the primary concern being the exclusion of malignancy.
• Accurate differentiation between benign and malignant nodules is crucial to minimize unnecessary surgeries.

Purpose of the Study:

• To evaluate the diagnostic accuracy of ultrasound (USG) and fine-needle aspiration cytology (FNAC) in differentiating malignant from benign solitary thyroid nodules.
• To assess the malignancy rates in solid versus mixed consistency cold nodules.

Main Methods:

• A study of 127 patients with solitary thyroid nodules who were clinically and biochemically euthyroid and had cold nodules on radionuclide scan.
• Diagnostic procedures included hormone assessment, USG, FNAC, and surgical intervention.
• Postoperative histopathological examination was used as the gold standard for diagnosis.

Main Results:

• Histopathology confirmed malignancy in 41 (32.3%) of the 127 solitary thyroid nodules.
• Solid cold nodules showed a 34.6% malignancy rate, while mixed cold nodules had a 21.7% malignancy rate.
• FNAC results indicated 65.5% benign, 7.8% suspicious, and 26.7% malignant findings.

Conclusions:

• Histopathology remains the definitive method for diagnosing malignancy in solitary thyroid nodules.
• While solid cold nodules exhibited a higher malignancy rate, the difference was not statistically significant compared to mixed cold nodules.
• Further research may refine diagnostic strategies to improve preoperative differentiation and patient management.