Case Report

Diagnosis dan penatalaksanaan nodul tiroid tunggal: Sebuah laporan kasus

Nyoman Pramudita , Anak Agung Gede Budhi Kusuma

Nyoman Pramudita
Dokter Magang Ilmu Bedah Rumah Sakit Umum Daerah Wangaya. Email: pramuditanyomann@yahoo.com

Anak Agung Gede Budhi Kusuma
Staff Dokter Spesialis Bedah RSUD Wangaya, Bali
Online First: September 10, 2021 | Cite this Article
Pramudita, N., Kusuma, A. 2021. Diagnosis dan penatalaksanaan nodul tiroid tunggal: Sebuah laporan kasus. Intisari Sains Medis 12(3): 677-681. DOI:10.15562/ism.v12i3.1099


Background: Thyroid nodules are abnormal lesions in the form of masses or nodules found in thyroid tissue. Thyroid nodules have a prevalence of about 8% in the adult population. A single thyroid nodule is asymptomatic and is generally discovered incidentally on physical examination or imaging. Diagnosis is made by physical examination, imaging examination and cytopathological examination. The management of a single thyroid nodule can be done by providing interventional therapy and surgery. The purpose of this case report is to describe the diagnosis and management of a single thyroid nodule case in Wangaya General Hospital.

Case description: A 52-year-old male patient came to the Surgical Clinic at Wangaya General Hospital with complaints of a lump on the left neck in the past eight months. The lump is felt to be enlarged and painless. The patient's diagnosis was confirmed by cytologic examination, which revealed a follicular nodule with a benign tendency. The patient was given surgical therapy in the form of left thyroidectomy.

Conclusion: Single thyroid nodule is quite rare. Treatment of a single thyroid nodule was adjusted according to the results of the cytologic examination. The prognosis for a single thyroid nodule with benign cytology results is generally reasonable. However, it is necessary to follow-up the patient considering the false negative value of the cytological examination.

 

Latar belakang: Nodul tiroid adalah lesi abnormal berupa massa atau nodul yang terdapat dalam jaringan tiroid. Nodul tiroid memiliki prevalensi sekitar 8% pada populasi dewasa. Nodul tiroid tunggal bersifat asimtomatik dan umumnya ditemukan secara tidak sengaja saat pasien melakukan pemeriksaan fisik atau pencitraan. Penegakan diagnosis dilakukan dengan pemeriksaan fisik, pemeriksaan pencitraan dan pemeriksaan sitopatologi. Penatalaksanaan nodul tiroid tunggal dapat dilakukan dengan pemberian terapi intervensi dan pembedahan. Tujuan pelaporan kasus ini adalah untuk menjabarkan diagnosis dan penatalaksanaan pada salah satu kasus nodul tiroid tunggal di RSUD Wangaya.

Deskripsi kasus: Seorang pasien laki-laki berusia 52 tahun datang ke Poli Bedah RSUD Wangaya dengan keluhan benjolan pada leher kiri sejak 8 bulan yang lalu. Benjolan dirasakan membesar dan tidak nyeri. Diagnosis pasien ini dikonfirmasi melalui pemeriksaan sitologi yang menunjukkan suatu nodul folikular dengan kecenderungan ke arah jinak. Pasien diberikan terapi pembedahan berupa tiroidektomi sinistra.

Simpulan: Nodul tiroid tunggal cukup jarang terjadi. Terapi nodul tiroid tunggal disesuaikan dengan hasil pemeriksaan sitologi. Prognosis nodul tiroid tunggal dengan hasil sitologi jinak umumnya baik, namun perlu dilakukan follow-up terhadap pasien menimbang nilai negatif palsu dari pemeriksaan sitologi.

References

Musa IR, Ahmad ME, Raddady FSA, Rabih WRA, Elsayed EM, Mohamed GB, Gasim GI. Predictors of a follicular nodule (Thy3) outcome of thyroid fine needle aspiration cytology among Saudi patients. BMC Res Notes. 2017;10(621):1-7.

Zou B, Sun L, Wang X, Chen Z. The prevalence of single and multiple thyroid nodules and its association with metabolic diseases in chinese: A cross-sectional study. International Journal of Endocrinology. 2020; 2020:1-11.

Uyar O, Cetin B, Aksel B, Dogan L, Beksac K, Akgul GG, Berberoglu U, Gulcelik MA. Malignancy in Solitary Thyroid Nodules: Evaluation of Risk Factors. Oncol Res Treat. 2017;40:360-363.

Maxwell C, Sipos JA. Clinical Diagnostic Evaluation of Thyroid Nodules. Endocrinol Metab Clin N Am. 2019;48(1):61-84.

Sidemen IGAPY. Nodul Tiroid Soliter. E-Jurnal Medika Udayana. 2014;3(8):1-7.

Mirfakhraee S, Mathews D, Peng L, Woodruff S, Zigman JM. A Solitary Hyperfunctioning Thyroid Nodule Harboring Thyroid Carcinoma: Review Of The Literature. Thyroid Research. 2013;6(7):1-15.

Lansford CD, Teknos TN. Evaluation of the Thyroid Nodule. Cancer Control. 2006;13(2):1-10.

Welker MJ, Orlov D. Thyroid Nodules. American Family Physician. 2003;67(3):559-566.

Sklar C, Whitton J, Mertens A, Stovall M, Green D, Marina N, Greffe B, Wolden S, Robison L. Abnormalities of the Thyroid in Survivors of Hodgkin's Disease: Data from the Childhood Cancer Survivor Study. The Journal of Clinical Endocrinology & Metabolism. 2000;85(9):3227-3232.

Agrawal C, Guthrie L, Sturm Ms, Stanek J, Martin L, Henwood-Finley M, Aldrink JH, Olshefski R, O'Brien SH. Comparison of Thyroid Nodule Prevalence by Ultrasound in Childhood Cancer Survivors With and Without Thyroid Radiation Exposure. J Pediatr Hematol Oncol. 2016;38(1):43-48.

Goel KS, Goel S. Clinical Approach to Management of Solitary Thyroid Nodule, A Concrete Plan in 42 Patients, in a Tertiary Centre. International Journal of Contemporary Medical Research. 2019;6(3):1-5.

Pemayun TGD. Current Diagnosis and Management of Thyroid Nodules. Acta Med Indones-Indones J Intern Med. 2016;48(3):247-257.

Desser TS, Kamaya A. Ultrasound of Thyroid Nodules. Neuroimag Clin N Am. 2008;18(3):463-478.

Monib S, Farkas N, Abdelaziz MI. A Prospective Observational Study Assessing the Relationship Between Solitary Thyroid Nodule Size and Incidence of Malignancy. Cureus. 2020;12(11):1-7.

Ghassi D, Donato A. Evaluation of the thyroid nodule. Postgrad Med J. 2009;85(1002):190-195.

Bomeli SR, LeBeau SO, Ferris RL. Evaluation of a thyroid nodule. Otolaryngol Clin North Am. 2010;43(2):229-238.

Wong R, Farrell SG, Grossmann M. Thyroid Nodules: Diagnosis And Management. Med J Aust. 2018;209(2):92-98.

Keh SM, El-Shunnar SK, Palmer T, Ahsan SF. Incidence Of Malignancy In Solitary Thyroid Nodules. The Journal of Laryngology & Otology. 2015;129(7):677-681.

Yeung MJ, Serpell JW. Management of the Solitary Thyroid Nodule. The Oncologist. 2008;13(2):105-112.

Arul P, Masilamani S. A Correlative Study Of Solitary Thyroid Nodules Using The Bethesda System For Reporting Thyroid Cytopathology. Journal of Cancer Research and Therapeutics. 2015;11(3):617-622.

McCoy KL, Jabbour N, Ogilvie JB, Ohori P, Carty SE, Yim JH. The Incidence Of Cancer And Rate Of False-Negative Cytology In Thyroid Nodules Greater Than Or Equal To 4 Cm In Size. Surgery. 2007;142(6):837-844.

Ospina NS, Maraka S, Ycaza AEE, Brito JP, Castro MR, Morris JC, Montori VM. Prognosis Of Patients With Benign Thyroid Nodules: A Population-Based Study. Endocrine. 2016;54(1):148-155.


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