Thyroid cancers in nodular goitres in Northwestern Nigeria

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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“…(16) Edino et al states that 72% of malignant patients are males, and 28% are females. (17) Thus, our study correlates with these values.…”

Section: Discussionsupporting

confidence: 86%

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

Siddiqui¹,

Moupachi²,

Baghel³

2018

jemds

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“…Some researchers have reported NG with malignant thyroid tumor, especially with papillary carcinoma 21–24. The rate of medullary carcinoma in NG is 4–7.44% 23, 24. At our medical institution, in 2,113 patients with NG in the same period, 80 (3.8%) cases were diagnosed as MTC.…”

Section: Discussionmentioning

confidence: 89%

“…The aim of this study was to analyze the prevalence and clinicopathologic characteristics of MTC associated with NG, and the prognostic factors for cases of MTC. Some researchers have reported NG with malignant thyroid tumor, especially with papillary carcinoma 21–24. The rate of medullary carcinoma in NG is 4–7.44% 23, 24.…”

Section: Discussionmentioning

confidence: 99%

Medullary thyroid carcinoma with nodular goiter carries an excellent prognosis

Wang

Zhao

et al. 2012

Journal of Surgical Oncology

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“…Hypoechoic appearance of malignant nodules is significant. Presence of micro calcifications in 40% malignant nodules as compared to 10% benign nodules is also significant (Tables 1-4) [7][8][9][10][11].…”

Section: Observations and Resultsmentioning

confidence: 99%