The Prevalence of Differentiated Thyroid Cancer in Multinodular Goiter versus Single Thyroid Nodule in Karbala | International Journal of Medical Sciences And Clinical Research

Authors

Zaid Ali Saad

M.B.Ch.B., F.I.B.M.S.
Dr. Sabah Kareem Hamza Al-Hussaini

M.B.Ch.B / C.A.B.S / F.I.B.M.S Consultant General and laparoscopic surgery, Iraq

DOI:

https://doi.org/10.37547/ijmscr/Volume06Issue07-05

Keywords:

Multi nodular goiter papillary thyroid cancer solitary thyroid nodule follicular thyroid cancer

Abstract

Background: Thyroid cancer is the most common cancer affecting the endocrine system, accounting for approximately 1% of all human cancers, thyroid cancer occurs in 5–15% of cases with thyroid nodules depending on age, sex, radiation exposure history, family history, and other factors.

Objectives: to determine the prevalence of differentiated thyroid cancer in patients with multinodular goiter (MNG) and single thyroid nodule undergoing surgery in Karbala city.

Methods: a prospective study that was conducted at Imam Al-Hussain medical city and Safeer Al-Hussain hospital, Karbala, Iraq, over a period of twelve months starting from 1st of December 2021 to 1st of December 2022. During this period a total of 100 patients (88 female and 12 male) undergo thyroid surgery for different causes have been enrolled in the study.

Results: The overall prevalence of differentiated thyroid cancer was (19%), there is a strong relationship between nodularity and pathology types .which shows 16 (66.7) of patients with follicular adenoma, 9 patients (60%) with papillary thyroid cancer, and all patients 4(100%) with follicular thyroid cancer were single thyroid nodule, while 45 (84.9) of patients with colloid goiter and all patients with thyroiditis were multi nodular.

Conclusions: the prevalence of malignancy was significantly higher in single thyroid nodule than multi nodular goiter, with papillary thyroid cancer being the most common histological subtype. But, the prevalence of malignancy in multi nodular goiter was also quite high and cannot be underestimated, ultrasonography and Fine Needle Aspiration Cytology are both important tools that predicting malignancy in suspicious thyroid diseases (nodular).

References

Dong, W., Zhang, H., Zhang, P., Li, X., He, L., Wang, Z., & Liu, Y. (2013). The changing incidence of thyroid carcinoma in Shenyang, China before and after universal salt iodization. Medical science monitor: international medical journal of experimental and clinical research, 19, 49.‏

Hegedüs, L., The thyroid nodule. New England Journal of Medicine, 2004. 351(17): p. 1764-1771.

Siegel, R., et al., Cancer statistics, 2014. CA: a cancer journal for clinicians, 2014. 64(1): p. 9-29.

Sherma, S.I., Thyroid carcinoma. The Lancet, 2003. 361(9356): p. 501-511.

BRENNAN, M. D., BERGSTRALH, E. J., van HEERDEN, J. A., & McCONAHEY, W. M. (1991, January). Follicular thyroid cancer treated at the Mayo Clinic, 1946 through 1970: initial manifestations, pathologic findings, therapy, and outcome. In Mayo Clinic Proceedings (Vol. 66, No. 1, pp. 11-22). Elsevier.‏

Collini, P., G. Sampietro, and S. Pilotti, Extensive vascular invasion is a marker of risk of relapse in encapsulated non‐Hürthle cell follicular carcinoma of the thyroid gland: a clinicopathological study of 18 consecutive cases from a single institution with a 11‐year median follow‐up. Histopathology, 2004. 44(1): p. 35-39.

Lang, W., H. Choritz, and H. Hundeshagen, Risk factors in follicular thyroid carcinomas. A retrospective follow-up study covering a 14-year period with emphasis on morphological findings. The American journal of surgical pathology, 1986. 10(4): p. 246-255.

Tunbridge, W., et al., The spectrum of thyroid disease in a community: the Whickham survey. Clinical endocrinology, 1977. 7(6): p. 481-493.

Vander, J.B., E.A. Gaston, and T.R. Dawber, The significance of nontoxic thyroid nodules: final report of a 15-year study of the incidence of thyroid malignancy. Annals of internal medicine, 1968. 69(3): p. 537-540.

Tan, G.H. and H. Gharib, Thyroid incidentalomas: management approaches to nonpalpable nodules discovered incidentally on thyroid imaging. Annals of internal medicine, 1997. 126(3): p. 226-231.

Hegedus, L., Clinical practice: the thyroid nodule [J]. N Engl Med, 2004, 351 (17): 1764–1771.

Mandel, S.J., A 64-year-old woman with a thyroid nodule. Jama, 2004. 292(21): p. 2632-2642.

Gharib H, Goellner JR: Fine-needle aspiration biopsy of the thyroid: an appraisal. Ann Intern Med 1993;118:282-289.

Marqusee E, Benson CB, Frates MC, Doubilet PM, Larsen PR, Cibas ES, Mandel SJ: Usefulness of ultrasonography in the management of nodular thyroid disease. Ann Intern Med 2000;133:696-700.

Kim DL, Song KH, Kim SK: High prevalence of carcinoma in ultrasonography-guided fine needle aspiration cytology of thyroid nodules. Endocr J 2008;55:135-142.

Pacini F, Schlumberger M, Dralle H, Elisei R, Smit JWA, Wiersinga W: European consensus for the management of patients with differentiated thyroid carcinoma of the follicular epithelium. Eur J Endocrinol 2006;154:787-803.

Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ, Mazzaferri EL, Mclver B, Pacini F, Schlumberger M, Sherman SI, Steward DL, Tuttle RM: Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 2009;19:1167-1214.