BACKGROUND

Many patients present to the surgical department with a thyroid nodule.

However not all require surgery and only 5–6% of these are malignant. There

are many methods to diagnose and predict malignancy in a thyroid nodule. This

study throws light on the usefulness of TSH estimation and its role in predicting

malignancy.

AIMS AND OBJECTIVES

1) To evaluate the utility of serum TSH estimation as a biochemical

predictor of malignancy in suspicious thyroid nodules.

2) To study the clinical presentation and management of various thyroid

malignancies.

MATERIAL AND METHODS:

This prospective study involved 50 patients admitted to Madurai medical

college, madurai with thyroid swellings suspicious of malignancy. A descriptive

analysis of clinical presentation and a correlation of TSH level and final

histopathology were done.

OBSERVATION AND RESULTS

Most patients were females. The Mean age of malignancy was 40 years

with a higher mean age in males (59 years) as compared to females (38 years).

Commonest presentation was a rapidly growing thyroid swelling of short

duration or development of secondary symptoms in a long standing goitre.

Majority of patients presented with a SNT. The incidence of malignancy was

higher in SNT (36%) compared to MNG (19%). 4 patients presented with

primary complaints other than a neck swelling. patients presented with cystic

swelling of neck which turned out to be cervical lymph node metastasis. The

incidence of neck nodes was 20% and distant metastasis was 0%. .Mean

preoperative TSH value in malignancy was higher compared to those with

benign disease. Incidence of malignancy increased with higher TSH values.

CONCLUSION

There is a definite relationship between higher TSH levels and

malignancy. TSH levels could be used as predictor in clinically suspect

malignant thyroid swelling with a benign FNAC report. In such cases where

TSH value is high, the FNAC can be relooked to confirm the diagnosis.