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Patient with tyroid nodules in the family medicine
Abstract
Introduction: Thyroid nodules are defined as limited changes in the thyroid structure. A smaller number of thyroid nodules are palpable, only 10% in women and 2% in males. The prevalence of non-imperfect nodules visualized by ultrasound exploration of the structure of the neck (thyroid incidents) is 50%. Not malignant nodes can be found in people with thyroid hyperplasia, inflammatory and autoimmune thyroid diseases, granulomas, hemorrhagic or colloid cysts. Follicular carcinomas include follicular (papillary, follicular, anaplastic and insular carcinoma) and parafollicular carcinoma (medullary carcinoma). Case report:Apatient born in 1965 appears in a family medicine clinic for heart palpitations, malaise, and mood swings. Due to right-sided vetriculomegaly, diffuse reductive changes of the brain parenchyma, sensorimotor neuropathy of the right median nerve, sensory neuropathy of the right ulnaris and radial nerve, depression and arterial hypertension, it is under the supervision of a neurologist, physiatrist, psychiatrist and cardiologist. Physical examination reveals an enlarged, squamous thyroid gland, an ultrasonographically heterogeneous calcified malignantly suspected nodule in the lower poleleft lobe, 18x15 mm in size. The patient is referred to the Department of Nuclear Medicine where an FNAB is done indicating the presence of malignant cells. At the decision of the Oncology Consulium, a total thyroidectomy is performed at the Thoracic Surgery Clinic, followed by radioiodine therapy (131-I). The histopathological findings are: carcinoma papillare lobblateralis sinistri glandulae thyreoideae gradus II-classic type, T1N0. After 24 months, the patient without signs of relapse of malignancy. Conclusion: Educating family medicine physicians in the field of thyroid ultrasound diagnostics and incorporating it into everyday practice would allow significant advances in the diagnostic evaluation of thyroid nodules at the primary care level.
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