Primary care evaluation of thyroid disease : which clinical group needs urgent surgical referral ?

Abstract EN

Objective : To identify the clinical groups of patients with thyroid disorders which need urgent surgical referral from the Primary Care Clinic.

Methods : The case records of all patients with various thyroid diseases referred from the Primary Care Clinic to the Surgical Clinics of King Khalid University Hospital, from January 1990 to December 1997 were retrospectively reviewed.

Patients’ characteristics, clinical findings and the final histological results were analyzed.

Results : Four hundred and twenty-eight patients comprised this study group, which included 390 female and 38 male subjects with a mean age of 41.7 (range, 12-70) years.

One hundred and seventy-two (40 %) patients were reported to have solitary thyroid nodule, 132 (31 %) diffuse thyroid goiter and 124 (29 %) multi-nodular goiter.

The overall incidence of malignancy in all groups was 11.2 %, solitary thyroid nodule showed the highest (14 %) and diffuse goiter the lowest (6.1 %) incidence of malignant tumors in this series.

Conclusion : The significant incidence of malignant lesions in solitary thyroid nodules demands urgent surgical consultation by the primary care physician.

Diffuse goiter can be managed in Primary Care Clinic unless associated with gross thyroid dysfunction or malignancy.