الفهرس 
REVIEW OF LITERATUREOnly 14 pages are availabe for public view
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Abstract
Background: Thyroid nodules are common condition. It is estimated that 3%
to 7% of world population have palpable thyroid nodules, and this prevalence
might reach 76% when US is used as a screening tool. When a thyroid nodule
is detected, the most important step in the assessment is to determine if it is
malignant or not, which is determined via fine needle aspiration biopsy
(FNAC). It is accepted that approximately 5% of all nodules are malignant.
Objective: To determine the optimal surgical strategy for individuals
undergoing surgery for follicular lesion thyroid nodule on preoperative fine
needle aspiration biopsy (FNA).
Patients and Methods: This was a comparative prospective randomized study
conducted on a total of 52 patients diagnosed with follicular lesion thyroid
nodule. They will be chosen from Ain shams university hospital –
Eldemerdash - and Damietta cancer institute (DCI) after obtaining the approval
from ethical committee of the department of surgery, faculty of medicine, Ain
Shams University.
Results: Total thyroidectomy was performed as the initial surgical procedure
in 8 of the 18 patients diagnosed postoperatively as malignant thyroid cancer
whereas hemithyroidectomy was performed in the other 10 patients who
underwent completion thyroidectomy. Considering the total population of the
study, hemithyroidectomy was found to be adequate surgical management for
18 patients (69%) while the remaining 8 patients (31%), who had a malignant
postoperative pathology, had to face a second surgical step which is a
completion thyroidectomy. On the other hand, we observed that total
thyroidectomy was an over-treatment in 16 patients (61.5%). In our study, no
permanent complications were reported in either groups.
Conclusion: In our study, we concluded that hemithyroidectomy was an adequate
management option in the majority of the studied cases. TIRADS 5 category of
ultrasound assessment is the only significant factor that could be relied on to
suspect malignancy in a follicular lesion thyroid nodule on FNAC and so total
thyroidectomy could be considered in such patients. In our study, no clinical or
demographic data are significant in suspecting malignancy in follicular lesion
thyroid nodule. The major challenge in the management of a follicular lesion
thyroid nodule remains the assessment as to which nodule requires surgical
intervention and which can be followed conservatively. New diagnostic tools are
needed to decrease the number of operations performed for benign pathology in
patients with a needle biopsy diagnosis of follicular lesion. Finally, the
management of follicular lesion thyroid nodule still an area of debate.
Keywords: fine needle aspiration biopsy, Follicular lesion thyroid nodule,
Hemithyroidectomy, Total thyroidectomy.
Introd