ABSTRACT

Aim: To highlight the surgical options and malignancy in the solitary cold nodule of the thyroid gland

Study Design: Prospective case series study

Settings: South Surgical Ward Mayo Hospital, Lahore

Duration: June 2018 to November 2019

Methods: All the patients above 12 years of age with the diagnosis of the solitary cold nodule of thyroid gland either referred from the periphery or directly admitted through the Out Patient Department Mayo Hospital, Lahore were included in the study

Results: Age ranged from 13-58 with the mean of 34 ± 9 years and 92% of the patients were female. Right lobe of the thyroid gland was involved in 62% and isthmus in 2% of the patients. All the patients were euthyroid and underwent surgery. FNAC showed adenomatous colloid goiter in 52% and papillary carcinoma of the thyroid gland in 4% of the patients. Lobectomy plus isthmusectomy was performed in 94% and total thyroidectomy in 4% of the patients primarily. Histopathology report showed adenomatous colloid goiter in 44%, papillary carcinoma of the thyroid gland in 8% and follicular carcinoma in 2% of the patients. Completion of total thyroidectomy was carried out in 6% of the patients. Surgical site infection was observed in 4% and transient hypocalcemia in 2% of the patients postoperatively. There was no mortality.

Conclusion: The solitary cold nodule of the thyroid gland is more common in females. Lobectomy plus isthmusectomy is the gold standard surgical option. Papillary carcinoma is the commonest malignancy in the solitary cold nodule of the thyroid gland.

Keywords: Solitary cold nodule, euthyroid, malignancy, lobectomy plus isthmusectomy, papillary carcinoma