The Risk of Thyroid Carcinoma in Multinodular Goiter Compared to Solitary Thyroid Nodules: A Prospective Analysis of 207 Patients

Abstract

Aim Assessment of risk of thyroid carcinoma in patients with MNG compared to those with STN. Methods Medical files and histopathology reports of 207 patients who underwent thyroidectomy over 5-year period were reviewed. Data including patient' age, gender, presentation, ultrasonography, FNAC, surgical procedures, final histopathologic diagnosis and types of malignant tumors were collected and analyzed. Results There were 135 patient's solitary thyroid nodule and 72 patients with multinodular goiter, 193 females and 14 male. Mean age was 36.68 ± 14.5 years (range 13-70). The prevalence of thyroid cancer was 26% (35/135) in STN compared to 24% (17/72) in MNG (Chi-Square = 8.593, p > 0.18). Only male gender (p = < 0.000005) and preoperative clinical, ultrasound finding and fine needle aspiration cytology resulted that impression of malignancy (p = 0.000082) were significantly associated with thyroid carcinoma. Conclusion Risk of thyroid carcinoma in STN and MNG is similar. The incidence of malignancy in thyroid nodules in overall is indeed high. For that clinically detected thyroid nodules should be treated with high degree of suspicion. Male patient and Rapid growth by history and hard fixed nodule by clinical examination and hypoechoic, micro calcification and cervical lymphadenopathy on USG were seen more frequently in malignant nodules. While age, number and size of nodules were not. Intraoperative assessment for hardness and fixedity of nodule and decision for total thyroidectomy at that time reducing need to second operation as completion thyroidectomy and its complication.