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Kakatiya Medical College, Warangal   Road Map to Benign Thyroid Disorders
DR RAMESH KOORAPATI   MS Dept of General Surgery
Evaluation of Thyroid Disorders ,[object Object],[object Object]
Clinical assessment   ,[object Object],[object Object],[object Object],[object Object],[object Object]
DIFFERENTIAL DIAGNOSIS UNILATERAL SOLITARY THYROID NODULE
DIFFERENTIAL DIAGNOSIS BILATERAL SYMMETRICAL *  PHYSIOLOGICAL   *   FUNCTIONAL ASYMMETRICAL *  MNG *  DOMINANT NODULE *  CARCINOMA THYROID *  THYROIDITIS
AETIOLOGICAL CLASSIFICATION OF  THYROID SWELLINGS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
INVESTIGATIONS ESSENTIAL ,[object Object],[object Object],[object Object]
SPECIAL INVESTIGATIONS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
FNAC ,[object Object],[object Object],[object Object]
LIMITATIONS OF FNAC   ,[object Object],[object Object],[object Object],[object Object],[object Object]
ISOTOPE SCANNING ,[object Object],[object Object],[object Object]
 
 
BENIGN THYROID DISORDERS - CLINICAL PRESENTATIONS ,[object Object],[object Object],[object Object]
SOLITARY NODULE THYROID DEFINITION:- DISCREAT SWELLING IN AN OTHERWISE IMPALPABLE GLAND
NORMAL ULTRASOUND BENIGN NODULE ON US Solitary / Dominant Nodule (Non – toxic)
SOLITARY THYROID NODULE  v/s DOMINANT NODULE
[object Object],Road Map to Benign Thyroid Disorders Normal Gland Solitary / Dominant Nodule (Non – toxic) Class I  (10%) Class II  (60 – 75%) Class III  (20%) Class IV  (5%) Class V  (5 – 15%) NON – DIAGNOSTIC NODULES BENIGN NODULES FOLLICULAR LESIONS SUSPICIOUS NODULES MALIGNANT NODULES
Road Map to Benign Thyroid Disorders False Negatives  with FNAC Solitary / Dominant Nodule (Non – toxic)
Road Map to Benign Thyroid Disorders False Negatives  with FNAC Solitary / Dominant Nodule (Non – toxic)
NON - DIAGNOSTIC NODULES  (Class I) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Road Map to Benign Thyroid Disorders Solitary / Dominant Nodule (Non – toxic)
[object Object],[object Object],[object Object],Road Map to Benign Thyroid Disorders Thyroid Cyst Solitary / Dominant Nodule (Non – toxic) Pure Colloid, completely cystic  on US Complex lesions Solid lesions Clinical and US  follow up Surgery Surgery
BENIGN NODULES   (Class II) Road Map to Benign Thyroid Disorders Isoechoic homogeneous subcapsular nodule (arrows) with regular margin Solitary / Dominant Nodule (Non – toxic)
[object Object],[object Object],[object Object],[object Object],[object Object],Road Map to Benign Thyroid Disorders Solitary / Dominant Nodule (Non – toxic)
LEVOTHYROXINE  ,[object Object],Road Map to Benign Thyroid Disorders Solitary / Dominant Nodule (Non – toxic) May be Considered MUST be Avoided ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SURGERY INDICATIONS ,[object Object],[object Object],[object Object],Road Map to Benign Thyroid Disorders Solitary / Dominant Nodule (Non – toxic)
[object Object],[object Object],[object Object],[object Object],[object Object],FOLLICULAR LESIONS   (Class III) Road Map to Benign Thyroid Disorders Solitary / Dominant Nodule (Non – toxic)
Road Map to Benign Thyroid Disorders FOLLICULAR ADENOMA Nodule shows micro follicles,  is sharply circumscribed by a capsule, and  there is no invasion of the capsule or blood vessels FOLLICULAR CARCINOMA with Vascular invasion Solitary / Dominant Nodule (Non – toxic)
[object Object],[object Object],[object Object],[object Object],[object Object],SUSPICIOUS NODULES   (Class IV) Road Map to Benign Thyroid Disorders Solitary / Dominant Nodule (Non – toxic)
MANAGEMENT OF SOLITARY THYROID NODULE
THANK YOU…

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