Predictors of Malignancy in Thyroid Nodules

Document Type : Original Article


Department of Surgery, Damietta Faculty of Medicine, Al-Azhar University, Egypt


Background: Better and early prediction of malignant thyroid nodule, and sure differentiation from benign one, is crucial need to decrease the rate of non-indicated surgeries.
The aim of the work: To find risk factors and predictors of malignancy in patients with thyroid nodule[s].
Patients and Methods:Fifty patients with thyroid nodule[s] were included. All patients were evaluated by history taking, clinical examination and laboratory investigations. Imaging studies included thyroid ultrasound [US]. All were also submitted to fine needle aspiration cytology [FNAC] before treatment by total or subtotal thyroidectomy. Excised tissues were sent to histopathological analysis.
Results:The incidence of malignancy was 22.0%. both benign and malignant groups were comparable as patient characteristics, complaints except the significant increase in cosmetic disfigurement among patients with benign nodules [92.3% vs. 45.5%].Patients with malignant nodules had a significant increase of ill-defined margins, intranodular vascularity and enlarged lymph nodes [72.7%, 63.6% and 72.7% vs 5.1%, 12.8% and 25.6% respectively].  Ill-defined margins, enlarged lymph node and high grade in FNAC were the predictors of thyroid malignancy.
Conclusion: Predictors of malignant thyroid nodules are ill- defined edges, enlarged lymph node and high grade in FNAC. This helps clinicians to spare more benign cases from surgical interference.


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