The present study was undertaken to review the results of our recent experiences for 302 thyroid nodules at Incheon Christian Hospital during last 5 years up to March, 1983.
The purpose of this paper is to evaluate the practical situation of thyroid nodules in Korea and to remain the current concepts on the management of benign and malignant nodules.
Results are summarized as follows:
1) Patients who received operations were composed of 246 cases of benign disease (81. 5%)
and 56 cases of thyroid cancers(18.5%).
2) The peak incidence of benign nodules was noted in the 3rd decade (33.3%) and malignant nodules was shown in the 4th decade.
3) The most common category of size was 2-4 cm(50.8%) in benign nodules and above 5 cm(35.7%) in malignant nodules.
4) On the radioiodine scanning, cold nodules were 66.6% in benign nodules and 91. 1% in malignant nodules. Thyroid cancer was present in 23.7% cases of all cold nodules. In T.F.T. and serum T3RU, T3, T4, and TSH analysis by radioimmunoassay, similar findings were revealed in benign and malignant nodules except cases of thyroiditis.
5) In the histopathological diagnosis, benign nodules included adenoma in 114 cases (46.3%); follicular adenoma in 107 cases(43.5%), papillary adenoma in 3 cases(1.2%), embryonal adenoma in 2 cases(0.8%) and hurthle cell adenoma in 2 cases(0.8%); adenomatous nodular goiter in 67 cases(27.2%) and simple colloidal goiter in 27 cases(10.9%); thyroiditis in 35 cases (14.2%) ; Hashimoto´s thyroiditis in 30 cases(12.2%), subacute thyroiditis in 3 cases(1.2%) and Riedel´s struma in 2 cases(0.8%). Malignant nodules included papillary carcinoma in 49 cases(87.5%), follicular carcinoma in 6 cases(10.7%); lower grade encapsulated type in 4 cases, high grade angioinvasive type in 1 case and hurthle cell carcinoma in I case; and undifferentiated carcinoma in 1 case(1.8%).
6) Combined diseases were occured in 6 cases with follicular adenoma and papillary carci-noma in 4 cases with Hashimoto´s thyroiditis and papillary carcinoma.
7) Cervical lymph node metastases in malignant nodules were present in 13 cases(23.2%) and radical neck dissection (modified or standard) was performed in 13 cases.
8) The incidence of locally invasive thyroid cancer was 17. 1%.
9) Most cases of benign nodules were treated with total lobectomy and subtotal thyroide-ctomy(87.0%). In malignant nodules, author chose near total thyroidectomy(30.6%), subtotal thyroidectomy(28.6%) and total thyroidectomy(10.7%). A radical neck dissection was accom-panied with 13 cases(23.2%) of thyroid cancer, but author didn´t choose a prophylactic disse-ction.
10) Post operative complications were developed in 8. 9% cases of benign nodules and 14.3% cases of malignant nodules.
11) Post operative thyroid hormone therapy(45 cases), external irradiation(5 cases) and radioactive iodine therapy(3 cases) were performed.
12) A current follow up information was available in 42 cases(75. 0%) of thyroid cancers and 2 cases of local recurrences were revealed.
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