Objective: To find out the frequency of malignancy in nodular goiters. Methodology: A total of 204 cases were studied in the department of ENT and Head and Neck Surgery, Hayatabad Medical Complex, Peshawar. The duration of this descriptive study was from June 1, 2008 to May 31, 2010. After taking informed consent, a detailed history was obtained. Clinical and laboratory investigations were carried out as an aid to diagnosis and determine the patients' fitness for surgery. Patients with nodular goiters were categorized into two categories i.e., Solitary thyroid nodule and multinodular goiter. Surgically resected thyroid specimens were examined histopathologically. The data was analyzed using SPSS 16.0 for windows to determine the frequency of malignancy in nodular goiter. Results: Ages of the patients ranged from 17 to 84 years with a mean age of 37 + 12.48 years. The male to female ratio was 1:3.5. 18.14% cases presented as solitary thyroid nodules (STN) and 81.86% as multinodular goiters (MNG). Out of the total 83.82% cases were benign and 16.18% cases were malignant. The prevalence of malignancy in multinodular goiter was 14.37% and in the solitary thyroid nodules as 24.32%. Papillary carcinoma was the commonest malignancy followed by follicular carcinoma. Conclusion: The prevalence of cancer is significant in nodular goiters and these malignant tumours are usually of the papillary type. Solitary thyroid nodules have more chances of being malignant than multinodular goiter.

/pdf/the-frequency-of-malignancy-in-nodular-goiter-a-single-2ge81dysky.pdf

The frequency of malignancy in nodular goiter - a single center study

Thyroid carcinoma is the leading cause of death among endocrine cancers second to carcinoma of the ovary. Now a day, the incidence of thyroid malignancy is increasing more rapidly than any other malignancy. But data on the prevalence of thyroid malignancy among thyroid enlarged patients were very limited in the study area. Therefore, this study was aimed to determine the prevalence of thyroid malignancies among thyroid enlarged patients. Data of 846 thyroid enlarged patients registered from January 2010 to February 2013 were collected from fine needle aspirate cytology and histology (for inconclusive and the neoplastic cases) log books. It was entered and analyzed using SPSS version 20. Odds ratio was calculated to assess the presence and strength of association between the outcome variable and the explanatory variables. P-values less than 0.05 were considered statistically significant. Among the 846 thyroid enlarged patients, 62(7.3%) were confirmed to have malignancy. Among malignancies papillary thyroid carcinoma was the leading, 28 (45.2%), followed by follicular thyroid carcinoma, 18 (29%), and the least type of thyroid malignancies were medullary thyroid carcinoma and hurtle cell carcinoma, each accounts 1 (1.6%). Severe form of thyroid malignancy, undifferentiated thyroid carcinoma, was also accounted significant proportion, 12.9%. Older patients having an age of greater than 60 years and patients with solitary thyroid enlargement were more affected by malignancy compared to the reference age group, 11–20 years and diffused type of enlargement respectively (AOR: 10.96 (3.15-38.1; AOR: 8.82 (3.49-22.32) respectively). The prevalence of thyroid malignancy was significantly high and the leading type of malignancy was papillary thyroid carcinoma followed by follicular thyroid carcinoma. Thyroid malignancy was found to have statistically significant association with type of enlargement and age.

/pdf/prevalence-and-types-of-thyroid-malignancies-among-thyroid-3lthi4soso.pdf

Prevalence and types of thyroid malignancies among thyroid enlarged patients in Gondar, Northwest Ethiopia: a three years institution based retrospective study

Background & objectives: Multinodular goitre is probably the most common endocrine problem in the world today. Neither a well formulated nor a simple procedure is available for the management of MNG, hence the need for the present study. The aim was to study the various modes of presentation, the distribution with respect to age and sex and the usefulness of histological evaluation. Methods: This was a retrospective study of 100 cases of thyroid lesions during the period of April 2009 to October 2010. Results: Adenomatous goiter was found to be the commonest lesion with a frequency of 52 cases (52%).Most of the patients were female accounting for 90.39%. Most of the cases (53.85%) were noted in 21-40 years age group. Commonest presentation was swelling in front of the neck noted in 98% of cases. Conclusion: Commonest histological observation in the present study was adenomatous goitre in 52%. Majority of the patients were females with a M:F ratio of 1:9.4, with the commonest age group being 31-40 yrs. Almost all patients presented with swelling in front of the neck, with other complaints being that of pain, discomfort, dysphagia, dyspnoea and features of hyperthyroidism

/pdf/histological-study-of-adenomatous-goitre-4540o75h7j.pdf

Histological Study of Adenomatous Goitre

Objective: To determines the frequency of thyroid malignancy in multinodular goitre in patients undergoing thyroidectomy. Methodology: A retrospective study was done in ENT unit of Mardan Medical complex(MMC) teaching hospital from 1st March 2010 to 30 June 2012. All patients who underwent thyroid surgery for multinodular goitre at MMC were included in the study. All data regarding age,gender,relevant investigation, ultrasonography, FNAC,type of surgery and post-operative histopathology reports were collected. Results: Out of 80 cases studied,9 cases were found to have malignancy. Th e remaining 71 cases had benign pathology, maximum cases of malignancy were found between 31-50 years of age. papillary carcinoma was the most common. Conclusion: Incidence of malignancy in multinodular goitre should not be overlooked as many of the patients with thyroid cancer can present wih multinodular goitre.

Frequency of malignancy in multinodular goitre: a review of 80 cases of multinodular goitre

Objective:   To determine the frequency and types of various malignancies in patients presented with multi-nodular goiter (MNG). Study Design:  Observational prospective study. Place and duration:   Conducted in the departments of Pathology and Surgery, Peoples University of Naqvi S.Q.H. 1 Associate Professor, Department of Pathology Peoples University of Medical and Health Sciences, Nawabshah Arijia D. 2 Assistant Professor of Surgery Ghulam Muhammad Mahar Medical College, Sukkur Arshad S. 3 Consultant Department of Surgery Ghulam Muhammad Mahar Medical College, Sukkur Memon J.M. 4 Professor and Head of Department Surgery Ghulam Muhammad Mahar Medical College, Sukkur Memon M.R. 5 Professor of Surgery Ghulam Muhammad Mahar Medical College, Sukkur Bozdar A.G. 6 Associate Professor of Surgery Ghulam Muhammad Mahar Medical College, Sukkur Medical and Health Sciences (PUMHS) Nawabshah, department of Surgery Ghulam Muhammad Mahar Medical College Hospital Sukkur, cases were also collected from the private clinics. Duration:  January 2008 June 2013. Patients and methods:   All adult patients irrespective of sex were recruited presented during the study period with MNG on clinical examination or on ultrasound of neck. The demographic data was collected on a pro-forma. Pre-operative fine needle aspiration cytology (FNAC) was performed of any dominant nodule which was suspicious on ultrasound examination. Serum TSH, FT 3 and FT 4 levels were also evaluated to deter-mine the toxic status of the patient. The patients were underwent total thyroidectomy and the resected speci-mens were sent in formalin for histopathological exa-mination, and after collection of reports the results were tabulated. Results:   In current study 144 patients having aged between 18 - 63 years were analyzed, including 18 (12.5%) male and 126 (87.5%) female. The male to female ratio was 1:7. The majority of patients were presented in 2 nd to 4 th decades of their life. All (144) of the cases were having major complain of swelling in front of neck of various duration. On histological exa-mination 132 (91.7%) were benign and diagnosed as MNG, while 12 (8.3 %) cases were diagnosed as mali-gnant lesion. The malignant lesion consists of papil-lary carcinoma in 09 (75%) cases. Follicular carci-noma was detected in 02 (16.7%) cases and madullary carcinoma was diagnosed in one case. Conclusion:   The current study highlights the risk of  malignancy in multinodular goiter. The frequency of malignancy in MNG was 8.3% present more in fema-les. The papillary carcinoma was the dominant variant. Key Words:   MNG, Throidectomy, Malignancy, Papi-llary Carcinoma.

Frequency and histopathological evaluation of malignancies in multinodular goiter

Introduction Thyroid nodules are among the commonly encountered surgical specimens in histopathology laboratory. Thyroid nodules can be solitary or multiple. Carcinoma of thyroid is uncommon accounting for only 1% of all human tumors. Annual incidence of thyroid cancer is 0.5 to 10:100,000 person’s world wide. The prevalence of carcinoma is lower in multinodular goiter (MNG) than in solitary thyroid nodule (STN) (2). Malignancy is seen in only 0 to 11% of patients with MNG and is usually an incidental finding in thyroidectomy specimens, and in 3 to 33% of patients with STN. Clinical assessment based on physical examination of thyroid nodule helps to distinguish cases having high risk of malignancy. Iodine uptake thyroid scan, ultrasonography of the gland and fine needle aspiration cytology (FNAC) can also play a significant role in establishing the preoperative diagnosis of malignancy, but FNAC is the modality of choice. One shortcoming of FNAC in MNG is false negative result because the needle may not go into the nodule on which the test needs to be done. However, its role in solitary nodule is well established. Help of ultrasound guidance for FNAC can be taken if the cell yield is poor on aspiration. STN is the most common indication for surgical resection as prevalence of malignancy is more in solitary nodules. However, the solitary nodules should be cold on thyroid scan because hot nodules are less likely to be malignant. Malignancy in thyroid is mostly seen in hypo functioning cold nodules which do not take up iodine. Men develop thyroid nodules less frequently than women. Another fact is that frequency of malignancy in STN is more common in men than in women. Solitary cold nodules in men should be thoroughly investigated. Malignant nodules need to be treated surgically whereas benign nodules can be managed conservatively. Thyroid malignancy does not cause hypo or hyperthyroidism. Patients with thyroid malignancy usually reveal normal thyroid function tests. This study is aimed to see the histological pattern and ascertain the frequency and pattern of malignancy in goiter and STN in both sexes so that recommendations can be made for management.

http://kemu.edu.pk/annals/apr-jun-2009/histopathological-evaluation-of-432-cases-of-goiter.pdf

M Imran Anwar

Papers

Histopathological Evaluation of 432 Cases of Goiter