TREATMENT OPTIONS FOR A SINGLE COLD THYROID NODULE: A SINGLE CENTER STUDY

Abstract

Background: A thyroid nodule that does not absorb radioactive iodine during a thyroid scan is called a single cold or cold thyroid nodule. Even though the majority of thyroid nodules are benign, the existence of a chilly nodule should raise suspicions since it might point to a greater risk of cancer. In this post, we will examine in-depth the many medical and surgical approaches that may be used to treat a single cold thyroid nodule.

Objectives: By examining 150 patients with isolated cold thyroid nodules, we aimed to determine the range of diseases linked to this condition, analyze demographic trends, and appraise the effectiveness of surgical therapies.

Study design: A single-center study

Duration and palace of study:  District Headquarter Hospital Mishti Mela, District Orakzai, KPK, Pakistan From October 1, 2021 till to   1st, October 2023

Methods: A single cold thyroid nodule requires both surgical and medicinal treatment. Radioactive iodine treatment and hormone suppression are available medical therapies. It may be essential to perform surgical procedures, such as a thyroid lobectomy or complete thyroidectomy. However, there are less invasive alternatives. Consistent observation guarantees the efficacy of selected techniques. For the best results, the decision-making process is guided by patient-specific considerations.

Results: We learned important information about the clinical and demographic features of a single cold thyroid nodule from our extensive research, which included 150 individuals. The cohort's gender distribution was noteworthy, with 90% of participants being female, highlighting a greater frequency in this population. The patients' ages ranged from 15 to 65, with a mean age of 35 ± 10 years, indicating that the illness affects people of all ages. Of the individuals with detected thyroid abnormalities, 64% of patients had difficulties in the right lobe and just 2% in the isthmus. This indicates that the nodules inside the thyroid gland are distributed asymmetrically. All 150 patients had surgical intervention as part of their therapy, and after surgery, they were all in a euthyroid condition. Important diagnostic data were obtained by fine-needle aspiration cytology (FNAC), which showed papillary carcinoma in 5% of patients and adenomatous colloid goiter in 50% of cases, highlighting the variety of diseases linked to solitary cold thyroid nodules. Surgical techniques were customized to each patient's unique features, with lobectomy plus isthmusectomy being the majority technique and 95% of treatments. Five percent of the individuals required a total thyroidectomy due to the nodule's unusual appearance. After surgery, histopathology studies revealed a range of results: 45% of patients had adenomatous colloid goiter, 9% had follicular thyroid cancer, and 3% had follicle-based thyroid cancer. In 7% of patients, total thyroid ectomy was necessary, highlighting the need for customized treatment plans. Surgical site infections occurred in 5% of patients after surgery, emphasizing the need for careful postoperative care. Furthermore, 3% of patients had transient Hypocalcemia, a common side effect of thyroid surgery. The fact that there were no cases of sudden death is encouraging and shows the safety of the surgical procedures carried out.

Conclusion: Our analysis of 150 individuals with isolated cold thyroid nodules shows that women are more likely to have them, that the pathologies are more varied, and that specific surgical treatments may lead to good results. The results highlight the significance of customized treatment plans in achieving the best possible results for individuals suffering from this thyroid issue.