thyroid nodules & cancer

Introduction 

-Thyroid nodules is the most common endocrinopathy 

-They are extremely common, particularly among women

– About 90% of palpable thyroid nodules are benign adenomas, colloid nodules, or cysts, but some are malignancies 

-Most patients with a thyroid nodule are euthyroid, but some are hypothyroid or hyperthyroid 

-The most common neoplasm is the follicular adenoma (benign thyroid nodule) 

– A thyroid nodule is more likely to be a cancer in a man than in a woman and in young patients (under 20 years) and older patients (over 60 years)

Symptoms & Signs 

-Thyroid nodules usually are asymptomatic

-neck discomfort, dysphagia, choking sensation, hoarseness

-Large substernal goiters can cause superior vena cava syndrome, characterized by facial erythema and jugular vein distention that progress to cyanosis and facial edema when both arms are kept raised over the head (Pemberton sign)

Diagnosis 

-Serum TSH, thyroid ultrasound, Fine-needle aspiration (FNA)

-radionuclide thyroid scanning

-the diagnostic procedure of choice is FNA 

Treatment 

Medical therapy, levothyroxine suppressive therapy, surgery, RAI therapy, Ultrasound-guided radiofrequency ablation

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