Online ISSN: 2515-8260

Keywords : thyroid swelling


A study to evaluate the incidence of thyroid malignancy among cases of thyroid swelling presenting at a tertiary care center in Delhi

Dr. Animesh Vatsa, Dr. Smita Pathak, Dr. Bindya Kour Bali, Dr. Vitesh Popli

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 2900-2905

Globally the most common indication for thyroid operation is a solitary nodule with the possibility of malignancy. Thyroid nodules are common in clinical practice. This study was carried out to estimate the incidence of benign and malignant thyroid lesions among the thyroid swellings after histopathological examinations following thyroidectomy.
Materials and Methods: This cross-sectional follow-up study was done among patients undergoing thyroidectomy between July 2017 to June 2019 by the Department of General Surgery, Institute Base Hospital, Delhi Cantt. The patients were selected consequently as and when they presented during the study period with thyroid swelling considering inclusion and exclusion criteria. A total of 50 patients were selected for the study. The selected patients were examined clinically. Among routine investigation, their reports of FNAC and histopathogical examination after excision were collected and used for analysis in the current study.
Results: FNAC findings of 50 cases showed that 39 were benign and rest 11 cases were malignant lesions, hence approximately benign and malignant ratio came to 3.55:1. Among the benign lesions, the most common lesion is multinodular or colloid goiter. Out of 11 malignant cases of FNAC finding, majority were papillary carcinoma. On histopathological examination of the excised mass, out of 11 cases that showed malignancy on FNAC, 7 cases (14%) were found to be malignant.
Conclusion: To conclude, it is not unusual to have a diagnosis of thyroid malignancy in a clinically benign thyroid swelling. Incidence of such malignancies is significant. Hence, the patients being treated conservatively for benign thyroid diseases should be followed-up regularly. Patients who opt out of surgery should be put on diligent screening of the swelling and any suspicious change in the swelling has to be tackled aggressively.

AIRWAY MANAGEMENT IN PATIENTS WITH THYROID SWELLING UNDERGOING THYROID SURGERY: A PROSPECTIVE STUDY

Mayank Rastogi, Shubhra Srivastava, Amala G. Kudalkar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 56-66

Aim: Airway management in patients with thyroid swelling undergoing thyroid  surgery.
Methodology: After approval from Institutional ethics committee, we conducted a prospective observational study including 60 consenting patients with thyroid swelling undergoing thyroidectomy. A standard OT protocol for routine pre anaesthetic check up was followed. The usual airway parameters such as mouth opening, MPC, slux, thyromental distance (TMD), neck movement were assessed. The euthyroid status of the patient was confirmed.
Results: In 54 (88.3%) patients propofol was used as induction agent. In 3 (5%) patients combination of dexmedetomidine & propofol was used as induction agent. In 2 (3.3%) patients sevoflurane and propofol was used as induction agent. In 1 (1.4%) patient etomidate was used as induction agent. 16 (26.7%) of patients required external laryngeal manoeuvre whereas 44 (73.3%) didn’t require external laryngeal manoeuvre. Highest percentage of patients 48.3% (29) were intubated in 15-30sec, 13 (21.6%). patients required 30-45 sec, 12 (20%) required less than 15 sec, while 6 (10%) patients required more than 45 sec. Maximum time required for intubation was 58 sec. 1 (1.7%) patient had complaint of hoarseness of voice post-operatively. 1 (1.7%) patient had tracheomalacia for which tracheostomy was done. 1 (1.7%) patient was not extubated due to prolonged surgery. no patient had post-extubation desaturation.
Conclusion: From this study we concluded that thyroid swelling accompanied with airway deformity is a risk factor for difficult intubation. A thorough preoperative history in all patients with thyroid swelling is mandatory and should include duration of thyroid swelling, pressure symptoms and radiological investigations of the neck and thorax.

SENSITIVITY AND SPECIFICITY OF FINE NEEDLE ASPIRATION CYTOLOGY [FNAC] IN A THYROID SWELLING

H.V. Nerlekar; A. M. Shah; C.Z. Perdeshi; Amol D. Langale; Umesh B. Choughele

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 4156-4161

The current study was observational study undertaken to study sensitivity and specificity of FNAC in a thyroid swelling. It was observed that majority of patients with goiter were in age group 31-40 years. The majority of patients with goiter were females 50 (89.29%) as compared to males 14 (73.68%). The carcinomas were also more prevalent in females as compared to males. The results of thyroid cytology must be assessed in conjunction with the clinical findings and other investigations like TFT and USG findings, in view of the possibility of false negative or false positive cytological diagnosis. The viability and applicability of cell pattern analysis in applying pattern analysis to the understanding of thyroid cytology is also seen in this study.