• Cristina COJOCARU State University of Medicine and Pharmacy “Nicolae Testemitanu”, Chisinau, Republic of Moldova
  • A. BOUR State University of Medicine and Pharmacy “Nicolae Testemitanu”, Chisinau, Republic of Moldova


The aim of the study was to improve the diagnosis and surgical treatment of thyroid nodules. Material and methods: During 2012-2022, a serial, retrospective and prospective clinical study was conducted on 124 patients, with clinically unresponsive thyroid nodules, with/without signs of compression on adjacent structures, and/or with suspected ultrasonographic, scintigraphic, cytological malignancy. Results: Depending on the hyperplastic (goiter), tumor (adenoma, carcinoma), or autoimmune etiology of nodules, surgical treatment consisted of total and subtotal thyroidectomies, unilateral hemithyroidectomies, nodules enucleation, isthmectomies, combined - unilateral hemithyroid-ectomies and enucleation of the nodule or partial contralateral lobe resections and total thyroidectomy with lymphadenectomy. In 82 patients was performed frozen section for intraoperative diagnosis of malignancy and establishing the definitive volume of thyroidectomies. Complications of the intra- and postoperative period were not determined, except for one patient who developed transient paresis of a recurrent laryngeal nerve due to posttraumatic edema in the early postoperative period, with complete recovery after one month. The relapse of pathology was not identified. Conclusions: Once detected, thyroid nodules require clinical and imaging surveillance regardless of nodule size. Surgical treatment is indicated for nodules with clinical and paraclinical signs of malignancy, refractory to conservative treatment, and those associated with compression signs. The time for surgery should be decided in common with endocrinologists, family physicians, and other specialists in every suspicious case.

Author Biographies

Cristina COJOCARU, State University of Medicine and Pharmacy “Nicolae Testemitanu”, Chisinau, Republic of Moldova

Faculty of Medicine, Department of Surgery No. 5

A. BOUR, State University of Medicine and Pharmacy “Nicolae Testemitanu”, Chisinau, Republic of Moldova

Faculty of Medicine, Department of Surgery No. 5


1. Tamhane S, Gharib H. Thyroid nodule update on diagnosis and management. Clin Diabetes Endo-crinol 2016; 2: 17 / doi: 10.1186/s40842-016-0035-7.
2. Mittal M, Ganakumar V, Shukla R, Kumar Garg, M. Thyroid Nodule: Approach and Management. Goiter - Causes and Treatment 2020 / doi:10.5772/intechopen.91627.
3. Salabè GB. Pathogenesis of thyroid nodules: histological classification? Biomed Pharmacother 2001; 55(1): 39-53 / doi: 10.1016/s0753-3322(00)00010-x.
4. Vanderpump MPJ. The epidemiology of thyroid disease. British Medical Bulletin 2011; 99(1): 39-51/ doi:10.1093/bmb/ldr030.
5. Durante C, Grani G, Lamartina L, Filetti S, Mandel SJ, Cooper DS. The Diagnosis and Management of Thyroid Nodules. JAMA 2018; 319(9): 914 / doi:10.1001/jama.2018. 0898
6. Țîbîrnă Gh, Țîbîrnă A, Lisița N, Bejenaru L. Particularitățile Evoluției Clinice ale Cancerului Glandei Tiroide în Republica Moldova. Buletinul Academiei de Ştiinţe a Moldovei. Ştiinţe Medicale 2020; 1(65): 312-326.
7. Sturza, R. Deficienţe nutriţionale de iod şi strategii de eradicare. Revista de Ştiinţă, Inovare, Cultură şi Artă „Akademos” 2015 ; 1(36) : 113-118.
8. Kocakusak A. Did Chernobyl accident contribute to the rise of thyroid cancer in Turkey? Acta Endocrinol (Buchar) 2016; 12(3): 362-367 / doi: 10.4183/aeb.2016.362.
9. Gharib, H Papini, E Garber, Jr Duick, Ds Harrell, Rm Hegedüs, L. et al. American Association of Clinical Endocrinologists, American College of Endocrinology, and Associazione Medici Endocrinological Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules - 2016 update. Endocrine Practice 2016; 22 (Suppl.1): 1-60.
10. Pirola I, Di Lodovico, E Casella, et al. Thyroid scintigraphy in the era of fine‐needle aspiration cytology. Clinical Endocrinology 2020 / doi:10.1111/cen.14379
11. Ebeed AE, Romeih, MAE, Refat MM, Salah NM. Role of ultrasound, color doppler, elastography and micropure imaging in differentiation between benign and malignant thyroid nodules. The Egyptian Journal of Radiology and Nuclear Medicine 2017; 48(3), 603-610 /doi:10.1016/ j. ejrnm. 2017.03.012.
12. Young J, Lumapas-Gonzalez CG, Mirasol R. The diagnostic accuracy of ultrasound guided fine-needle aspiration biopsy and intraoperative frozen section examination in nodular thyroid disease. J Asean Fed Endocr Soc. 2011; 26(1): 44-50 /
13. Pezzolla A, Lattarulo S, Madaro A, et al. What really is an indeterminate FNA thyroid nodule? Ann Ital Chir 2017; 88: 275-281.
14. Unlu MT, Kostek M, Aygun N, Isgor A, Uludag M. Non-Toxic Multinodular Goiter: From Etiopathogenesis to Treatment. Sisli Etfal Hastan Tip Bul 2022; 56(1): 21-40 / doi: 10.14744/SEMB. 2022. 56514.
15. Cappelli C, Pirola I, Agosti B, et al. Complications after fine-needle aspiration cytology: a retrospective study of 7449 consecutive thyroid nodules. Br J Oral Maxillofac Surg 2017; 55(3): 266-269 / doi: 10.1016/j.bjoms.2016.11.321.
16. Jackson BS. Controversy regarding when clinically suspicious thyroid nodules should be subjected to surgery: Review of current guidelines. Medicine (Baltimore) 2018; 97(50): e13634 /doi: 10.1097/MD. 0000000000013634.
17. Fligor SC, Lopez B, Uppal N, et al. Time to Surgery and Thyroid Cancer Survival in the United States. Ann Surg Oncol 2021; 28, 3556-3565 /