The Incidence of Malignancy in Multi-nodular Goitre: A Prospective Study at a Tertiary Academic Centre 267-270
Dr. Hanumanthappa M.B.
Department of Surgery, AJ Institute of Medical Sciences,
Mangalore 575004, India.
Introduction: Multi-nodular goitre (MNG) is one of the common presentations of various thyroid diseases. Thyroid nodules have been reported to be found in 4% to 7% of the population on neck palpation. Although MNG was traditionally thought to be at a low risk for malignancy as compared to its single-nodule counterpart, various studies have reported a significant risk. The objective of this study was to determine the incidence and the type of thyroid carcinoma (TC) in multi-nodular goitre by doing the histopathological examination of thyroidectomy specimens.
Materials and Methods: This prospective, observational study was carried out in the Department of Surgery at the AJ Hospital and Research Centre (a tertiary academic referral centre), Mangalore, India from Jan 2007 to Dec 2010. All the patients with multi-nodular goitre with or without thyrotoxicosis were evaluated and they were offered surgery as the treatment for suspicious findings, cosmesis, compressive symptoms and thyrotoxicosis. The specimens were subjected to a histopathological evaluation to determine the incidence and the types of various malignancies in MNG.
Results: Among the 100 MNG cases which were studied, 10 (10%) cases contained malignant foci. Among them, papillary carcinoma (60%) was the most common type of malignancy which was observed.
Conclusion: The incidence of malignancy in MNG is quite significant and it is not very low as was thought before. Due to the risk of occult malignancy, all the patients with multi-nodular goitres who are treated conservatively need a close follow up for malignancy.