Factors associated with malignancy in patients with thyroid nodules.

Background: Due to the development of diagnostic techniques, the incidence of thyroid nodule reporting is increasing. Most of these cases may be managed conservatively, but it is important to identify those with a high suspicion of malignancy. The aim of this study was to identify factors that relate to malignancy in patients with thyroid nodule.

Methods: We reviewed the files of all patients with thyroid nodule who underwent surgical treatment in a Head and Neck Surgery Department in a third-level hospital during a 3-year period.

Results: There were 114 patients; 103 were female. Median age was 48 years old with a mean nodule size of 3.3 cm. Surgeries performed were 54 hemithyroidectomies, 10 total thyroidectomies, 48 total thyroidectomies and central nodal dissection (level VI), 1 partial resection, and one istmectomy. In 64 patients, the final diagnosis was benign, adenoma being the most common diagnosis. In 50 patients the nodules were malignant, predominantly papillary carcinoma (42 cases). Factors related to malignant nodule were age < 40 years (p < 0.05), firm consistency (p < 0.01), fixed nodule (p < 0.01) and microcalcifications (p < 0.01) and solid or mixed appearance assessed by ultrasonography.

Conclusions: This study shows that clinical characteristics and ultrasonography results may be used to identify high risk patients with thyroid nodules.