Accuracy of ultrasound-guided fine-needle aspiration cytology for diagnosis of carcinoma in patients with multinodular goiter

Al-Yaarubi, Saif; Farhan, Hatem; Al‐Futaisi, Amna; Al-Qassabi, Salim; Al-Rasadi, Khalid; Al-Riyami, Shaden; Al‐Zakwani, Ibrahim

doi:10.4103/2230-8210.83352

Cited by 13 publications

(12 citation statements)

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“…According to our data and the reports of Ríos et al [ 23 ] and Al-Yaarubi et al, [ 24 ] FNAB is not useful for differentiating between benign and malignant goiters in patients with MNG because of its low sensitivity rate of 14% to 17%. The possible reason for this may be related to tumor foci that are too small to enable a preoperative diagnosis.…”

Section: Discussionmentioning

confidence: 40%

Patient outcomes following surgical management of multinodular goiter

Lin

et al. 2016

Medicine

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Background:the difference in the risk of thyroid malignancy for patients with multinodular goiter (MNG) and solitary nodular goiter (SNG) remains controversial. Although total thyroidectomy (TT) is the current preferred surgical option for MNG, permanent hypothyroidism in these patients may be a concern. Therefore, we discuss whether nontotal thyroidectomy is a reasonable alternative surgical option.Methods:A retrospective cohort study was performed for 1598 consecutive patients who underwent thyroid surgery for nodular goiter between January 2007 and December 2012. Numerous clinical parameters were collected and analyzed.Results:We reviewed 795 patients with MNG and 803 patients with SNG. The prevalence of malignancy on final pathology was significantly higher in the patients with MNG than in the patients with SNG (15.6% vs 10.1%, P = 0.001). However, a multivariate analysis revealed that this difference was insignificant (P = 0.50). Papillary carcinoma was the predominant type in both groups, but papillary microcarcinoma was more frequently found (41.1%) in the patients with MNG. The only multifocal cancers were of the papillary carcinoma histologic type, and the incidence of multifocal papillary carcinoma was significantly higher in the patients with MNG (23.4% vs 7.4%, P = 0.005). Reoperation was not required for the patients who underwent TT for goiter recurrence or incidental carcinoma. The overall rate of recurrence following nontotal thyroidectomy was 12.2%. Among the patients who underwent reoperation for goiter recurrence, 2 (20.0%) were complicated with permanent hypoparathyroidism. Among the patients who underwent a nontotal bilateral thyroidectomy, an average of 56.5% had permanent hypothyroidism.Conclusions:Multinodularity does not increase the risk of thyroid malignancy. However, patients with MNG who develop papillary carcinoma are at an increased risk of cancer multifocality. If a patient can tolerate lifelong thyroid hormone replacement, TT is the preferred surgical option because it helps avoid reoperation and the associated complications. Nontotal bilateral thyroidectomy does not ensure the preservation of thyroid hormone function.

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Section: Discussionmentioning

confidence: 40%

Patient outcomes following surgical management of multinodular goiter

Lin

et al. 2016

Medicine

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“…According to study by Yaarubi et al on 136 patients with multinodular goitre, the mean age was 39 ± 13 years with an age ranginf from 5 to 85 years. (13) According to Khalid et al, the mean age of presentation of multinodular goitre is 32.2 ± 11.58 years with a range of 13 to 90 years. (14) In retrospective, consecutive analysis by Hee-Nee Pang and Chung-Ming Chen, the mean age of patients with nodular goitres was 48 years.…”

Section: Discussionmentioning

confidence: 99%

“…Comparison of Multinodularity with other Authors Mosawi et al (10) Saddique et al (11) Bagga and Mahajan (12) Yaarubi et al (13) 1…”

Section: Our Studymentioning

confidence: 94%

A Clinical, Bio-Pathological Study of Multinodular Goitre in Rewa Region, Madhya Pradesh

Siddiqui¹,

Moupachi²,

Baghel³

2018

jemds

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BACKGROUND Multinodular goitre is the most prevalent thyroid gland biochemical change and pathology. Multinodular goitre is a condition with various clinical presentations. Although, the majority are benign, the incidence of occult malignancy in multinodular goitre varies from 1.2% to 16.66%. Accurate preoperative diagnosis of malignancy is therefore very important for appropriate management of the patient with multinodular goitre. MATERIALS AND METHODS This is a descriptive study of 23 patients attended in outpatient department and inpatient department with multinodular thyroid swelling from July 2015 to February 2016 at the Otorhinolaryngology Department, Gandhi Memorial and Sanjay Gandhi Memorial Hospitals, Shyam Shah Medical College, Rewa (MP). After registration of patients, a detailed history was taken and thorough clinical examination was carried out, which was entered in the proforma. All the patients underwent routine investigations, thyroid profile, x-ray and FNAC. Multinodular goitre specimen were sent for histopathological examination (HPE). 15 age and sex matched healthy control group were compared for thyroid profile. RESULTS 23 patients were selected for our descriptive study. Mean age for benign lesion was 39.5 years and for the malignant lesion was 33.5 years. Two peak incidences for malignant lesions were noted. Greater peaks for age groups are between 21-30 years with 50% of all cases of malignancy. Female-to-male ratio for malignancy was 0.8: 1. The average duration of symptom for malignancy was 2.46 years and for benign was 4.38 years. There was one false positive and one false negative FNAC result. Histopathology showed 8.69% patients had malignancy. Multinodular goitre (86.95%) was the most common diagnosis histopathologically among benign diseases. Papillary carcinoma was the most common malignant lesion. The overall sensitivity of fine needle aspiration cytology in multinodular goitre in our study was 80%. Thus, FNAC and thyroid profile are very good diagnostic tools preoperatively. CONCLUSION Multinodular goitre is the commonest thyroid disease in Rewa (MP), more common in males with chief complaints of symptomless swelling in front of the neck. The malignancy rates were slightly higher in males compared to females. 86.95% of the multinodular goitre were benign and 8.69% were malignant. Papillary carcinoma was the most common malignancy. FNAC and thyroid profile are a very good diagnostic tool for detection of multinodular goitre preoperatively.

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“…Recently, Antonio Rios et al [15] reported that FNA is not useful for differentiating MNG with malignant degeneration from benign MNG, as more than 80 % of carcinomas go unnoticed. Al-Yaarubi et al [16] mentioned that sensibility and specificity of FNA in determination of malignancy in MNG cases are 16 and 97 %. So, in our survey, incidental malignancy within the pathology specimen was determined in 16 patients (6 cases in DO group and 10 cases in TT group).…”

Section: Discussionmentioning

confidence: 99%

Comparison of the results of total thyroidectomy and Dunhill operation in surgical treatment of multinodular goiter

et al. 2015

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Multi-nodular goiter (MNG) is one of the commonest thyroid gland disease. Surgery is an important treatment option in the presence of indications. There are several alternative procedures for thyroid gland operation such as subtotal thyroidectomy (STT), near-total thyroidectomy (NTT), hemi-thyroidectomy plus subtotal resection (Dunhill procedure), and total thyroidectomy (TT), but the surgical procedure of choice is still under discussion. In this study, 173 consecutive patients with multi-nodular goiter underwent thyroid operation in the department of surgery of Pursina Hospital in Rasht-Iran, using two different methods: Dunhill operation and total thyroidectomy. Outcome assessment was performed 4 days after surgery, 2 weeks, 1, 2, 10, and 20 month after surgery. Preoperative assessment, seroma, recurrent laryngeal nerve palsy, hypocalcaemia rates, and rates of other postoperative complications, final pathology, and recurrence were compared in two methods. Due to the high incidence of malignancy in this survey, TT can be the method of choice for MNG surgery. Also, TT will be more beneficial in the surgical treatment of benign thyroid disorders, especially those which are bilateral or extended to substernal space or which presented with compression symptoms.

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Accuracy of ultrasound-guided fine-needle aspiration cytology for diagnosis of carcinoma in patients with multinodular goiter

Cited by 13 publications

References 9 publications

Patient outcomes following surgical management of multinodular goiter

Patient outcomes following surgical management of multinodular goiter

A Clinical, Bio-Pathological Study of Multinodular Goitre in Rewa Region, Madhya Pradesh

Comparison of the results of total thyroidectomy and Dunhill operation in surgical treatment of multinodular goiter

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