CLINICAL IMPORTANCE OF THYROID NODULES

Abstract

Objectives. Thyroid nodules, although are found, in the general population, with a rate of 50-65%, have become an interdisciplinary clinical problem, in the endocrine surgery, unsolved so far due to their malignancy and a lack of consensus on diagnostic-curative management. The aim of the study was to optimize the tactics of diagnosis and surgical treatment of thyroid nodules.
Material and methods. In the period from 2012 to 2020, was performed a serial clinical study, which included 84 patients aged between 19-69 years old, who presented, clinically and paraclinically, thyroid nodules larger than 0,5 cm, with rapid growth over a year, without a positive outcome to conservative treatment. Additionally, patients were examined by serological tests, Doppler ultrasonography, sonoelastography, scintigraphy and fine needle aspiration-biopsy.
Results. Paraclinical significant benchmarks of thyroid nodules (elevated levels of serum thyrotropin, calcitonin and anti-thyroid antibodies, ultrasonography classes TI-RADS 4, 5, scintigraphic pattern of "cold nodules", cytopathologically – Bethesda categories IV, V, VI) correlated with the clinical benchmarks, determined the need for surgical treatment. The volume of the surgical interventions was established following the result of the extemporaneous histological investigation.
Conclusion. The clinical importance of the thyroid nodules consists of the need to assess the malignant potential, dysfunction of the thyroid gland, the degree of compression on adjacent structures, and solving them by selecting the reasonable method of treatment.