A RARE PRESENTATION OF A SOLITARY RIGHT LOBE THYROID NODULE IN THE BACKGROUND OF MULTINODULAR GOITER

This case is about a 41-year-old female who presented with a solitary thyroid nodule in the right lobe. She had swelling in the front of her neck for 5 years, weight gain for 1 year, hair loss for 2 years, and palpitations for 1 year, but no other medical illnesses. Blood investigations showed haemoglobin 11.9 g/dL, red blood cells 4.65 million/cumm, hematocrit 37.5%, platelets 3.45 lakh/cumm, and white blood cells 8530/cumm with normal differential counts. Coagulation profile was normal with PT 11.8, INR 0.91, and APTT 31.7. Liver and kidney function tests were normal, with total bilirubin at 0.7 mg/dL and serum creatinine at 0.7 mg/dL. Electrolytes were also normal. HbA1c was 4.8%, showing no diabetes. Thyroid function test revealed low TSH (0.20 mIU/L), normal Free T3 (3.21 pg/mL), and slightly high Free T4 (1.80 ng/dL). Ultrasound of the thyroid showed a right lobe nodule classified as ACR TIRADS 3, mildly suspicious for malignancy, but FNAC confirmed colloid goiter, a benign condition. The patient was managed with right hemithyroidectomy under general anesthesia, which she tolerated well, and the postoperative recovery was uneventful. During treatment, she received intravenous antibiotics (Inj. Xone 1 g) for infection control, a proton pump inhibitor (Inj. Pan 40 mg) to prevent stomach acid secretion, an antiemetic (Inj. Emeset 4 mg) for nausea and vomiting, paracetamol (Inj. PCT 1 g) for fever and pain, tramadol for additional pain relief when required, vitamin supplements (Tab Limcee, Tab Cofovit) for nutritional support, and cough syrup (Syp Ascoril D 30 ml) for dry cough. She is now hemodynamically stable and has been discharged with medical advice, highlighting the importance of proper evaluation and treatment planning for solitary thyroid nodules.