Pattern of Thyroid Lesions in Western Region of Saudi Arabia: A Retrospective Analysis and Literature Review

Abstract

BackgroundUltrasonography (US) is being recognized as a traditional way of the diagnosis of various thyroid disorders, and this will help in detecting the thyroid tumors in early stage. Thyroid nodules are common and usually benign; steps to diagnose malignancy should include a careful clinical evaluation, laboratory tests, a thyroid US exam and a fine-needle aspiration (FNA) biopsy.MethodsA total of 173 registered cases were used for analysis in this study. Diagnosis was made following US-guided FNA cytology (FNAC) and histopathological diagnosis; clinicopathological and demographic data of all such patients were obtained and analyzed for the present study. For statistical analysis, Statistical Package of Social Sciences v.22 (SPSS) was used.ResultsIn the current study, 87.3% of patients were female, and 12.7% were male. The mean age of the patients was 43.35 years, 86.4% were Saudi nationals and there was no significant difference between age groups. Overall, the distribution of lesions in all age groups was 41.6% in the right lobe, 9.3% lesions were adenomatous, 71.1% were colloid, and 10.4% were lymphocytic. The final diagnosis of thyroid lesions was confirmed after histopathological examinations. Out of 173 cases, 12.6% (20 cases) of male patients and 87.4% (139 cases) of female patients had benign lesions, respectively. Only one male case was malignant, and seven cases were malignant in female group. Eighty percent of males and 77.7% females have colloid nodules, and 15% of males and 9.3% of females have adenomatous nodules. Four cases were non-diagnostic, one case was atypia in females, and one case was suspicious of malignancy in a male.ConclusionsMost thyroid lesions in this study population were benign, while papillary carcinoma was the most common malignancy encountered. There was a marked female predominance in all types of thyroid diseases. The most common age group affected is 30 - 39 years. In Saudi Arabia, growing prevalence of thyroid cancer may be due to the increased screening using sensitive imaging in clinical practice, and ultrasonography is the most accurate and cost-effective method for detecting thyroid lesions.

Thyroid cancer among patients with thyroid nodules in Yemen: a three-year retrospective study in a tertiary center and a specialty clinic

“…A high prevalence of thyroid cancer was seen in our patients with thyroid nodules (13.4% of the females and 18.4% of the males), and there was no significant difference in the rate of cancer among those with single nodules and multiple nodules (P value = 0.07); this is similar to what was reported by Frates et al [16], and the highest rate of cancer was among those with nodules 1-2 cm in size; this is similar to a study that showed the highest malignancy rate among nodules < 2 cm in size [17]. The overall prevalence of cancer among patients with thyroid nodules was 13.8%, which is higher than that in neighboring countries, which is reported to be approximately 9-10% [8][9][10]. TSH level was significantly associated with thyroid cancer (P -value 0.01), which is consistent with studies that showed an increased risk of thyroid cancer with an increase in TSH level [12,18].…”

“…Other countries with high incidence rates include the USA (13.2), Canada (12.7), Turkey (10.9) and Italy (10.8) [6,7]. Other studies from the Middle East showed thyroid cancer in 10.5% of patients with thyroid nodules in Jordan [8] and rates of 5% in Saudi Arabia in one study [9] and 10.4% in another [10]. In the United Arab Emirates, the prevalence was 9% among those of Emirati origin [11] and 5% among those with thyroid nodules in Pakistan [12].…”

Diagnostic accuracy of ultrasonography versus fine-needle-aspiration cytology for predicting benign thyroid lesions

“…In the current study, thyroid lesions affected females more than males (85% vs. 15%), this result was consistent with multiple previous studies by Saeed MI et al, Richman DM et al, Ram N et al, and Germano A et al, who reported lesion rates in females of 87.3%, 82.8%, 80%, and 79%, respectively 13-16. The results were also consistent with a previous study by Dalia et al, who reported that TNs in females are four times more common than in males.…”

“…This study identified benign lesions in 106 (84.1%) female cases and 20 (15.9%) male cases, but all malignant cases were in females. These results were consistent with those of Saeed et al, who reported that benign lesions were 87.4% in females and 12.6% in males, while malignant lesions were 87.5% in females and 12.5% in males 13…”

Epidemiology of cancer in Saudi Arabia thru 2010–2019: a systematic review with constrained meta-analysis<span style="font-size: 12px"> Running title: epidemiology of cancer in Saudi Arabia thru 2010–2019</span>

“…The incidence is more common among females compared to males. The prevalence of thyroid cancer 10.1% [5] and the common malignant type being papillary thyroid carcinoma [27] .…”