One thousand and fifty five patients with thyroid nodules who underwent thyroidectomy at the department of surgery, Seoul National University Hospital between August, 1983 and July. 1993 were clinically analyzed and the follow-up study was
performed for
the patients.
Of the thyroid nodules, the benign was 63.7% and the malignant was 36.4%. The malignancy ratio was increasing in tendency according to the diagnostic improvement and strict application of the surgical indications. Of the benign nodules, 83.9% was
the
adenomatous goiter, 13.3% was the follicular adenoma, and 1.9% was the Hashimoto's disease. Of the malignant nodules, 83.6% was the papillary carcinoma, 12.0% was the follicular carcinoma, 1.3% was the medullary carcinoma, and 2.9% was the
anaplastic
carcinoma.
The thyroid nodules were commonly observed between the thirties and fifties of age. The malignancy ratio, however, was significantly high under the tenth and over the fifties of age. The male to female ratio was 1 to 8.3 in the benign and 1 to
5.6
in
the malignant. The malignant ratio was higher in males.
The nodules were common in the right lobe and bilateral lesions were more common in the benign nodules. The possibility of malignancy was higher in the solitary rather than multiple, and in the solid rather than cystic lesions.
The nodules fell mostly between 1.6 cm and 3.0 cm in size. The malignancy ratio, however, was significantly higher in the nodules under 1.5cm in size and over 6.1cm as well. The possibility of coexisitence of malignant disease was 7.5% in the
benign
nodules.
There were lymphnode metastases in 59.5% of the papillary, 2.2% of the follicular, 80% of the medullary, and 100% of the anaplastic carcinomas. The distant metastatic cites commonly observed were the lung in the papillary and anaplastic, and the
spine
in the follicular carcinomas.
The operation frequently performed was total lobectomy with or without isthmectomy for the benign, and subtotal thyroidectomy for the malignant nodules. The recurrence was not related to the extent of thyoidectomy itself but the status of
metastasis and
the operation on the neck nodes as well. The rate of complications was higher in the cases with malignant nodules than in the benign cases.
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