Endocrine Abstracts

Background

The thyroid nodule is a common presentation. Its prevalence is estimated to be 5%. Surgical treatment could not be systematic. It requires structured diagnostic approach to ascertain the risk of malignancy and determine appropriate management.

Aim

To evaluate potential role of epidemiological, clinical and para clinical criteria as preoperative indcators of malignancy in thyroid nodules.

Methods

This is a retrospective analytical study of 304 cases of patients who undergone surgery for thyroid nodule in ENT Departement of Farhat Hached Hospital from 2012 to 2019.

Results

The median age at diagnosis was 44, 73 years. It is more common in women with sex-ratio (M/F) is 0.1. Cancer risk is 36%in men versus 25.1%in women. The mean delay of consultation was 12 months(extrêmes de 1 à 276 moths). Family history of thyroid disorders were present in 10.2%of cases. Personal history of goiter was found 12 patients (3.9%). de compressive symtomps were detected in 22.7%of cases. Cervical lymph nodes were présentes in 36 patients (11.8%of cases). Hard consistency was found in 44 patients (14.5%). Le nodule was fixed in 38 patients (12.5%). Margins were irregular in 23 patients (7.6%). Several US features have been found to be indicative of malignant potential. Microcalcifications(33.6%, p), irregular limits(46 Patient, 15.1%), or microlobulated margins(28 patients (9.2%), hypoechogenicity (95 pateinst, 31.3), taller-than-wide shape(70 patents, 23%), and increased intranodular vascularity(118 patients, 39%) were found to be independent risk factors for malignancy. Scintigraphy with technétium99 was performed in 15.9%of cases and FNA in 16%of cases. An analatycal study was concucted in order to determnates pedictive factors of malignancy:family history of thyroid disorder, personal history of thyroitidis, goiter, hard consistency (P < 0.001), fixity (P < 0.001), irregular limits (P = 0.002, cervical lymph nodes(P < 0.001), and flush syndrome (P = 0.007), hypoecgogenecity (P < 0.001), blurred margins(P < 0.001), taller-than-wide shape (P = 0.002), microcalcifications (P < 0.001), , intranodular vascularisation (P = 0.003) and the score EUTIRADS V (P < 0.001).

Conclusion

The risk stratification based on clinical features and US findings is useful to determinate the convenient management of thyroid nodules.