Volume 1 • Issue 3 • 1000115
Thyroid Disorders Ther
ISSN: 2167-7948 JTDT, an open access journal
Research Article Open Access
Nikhil Nanjappa et al., Thyroid Disorders Ther 2012, 1:3
http://dx.doi.org/10.4172/2167-7948.1000115
Review Article Open Access
Thyroid Disorders & Therapy
Thyroid Carcinoma (Tc) in Nodular Goitre
Nikhil Nanjappa BA
1
*, Alok Mohanty
1
, Tirou Aroul T
1
, Robinson Smile S
1
and Dhananjay Kotasthane
2
1
Department of Surgery, Mahatma Gandhi Medical College & Research Institute, Pondicherry, India
2
Department of Pathology, Mahatma Gandhi Medical College & Research Institute, Pondicherry, India
*Corresponding author: Nikhil Nanjappa BA, Department of Surgery, Mahatma
Gandhi Medical College & Research Institute, Pondicherry, India, Tel: +91-
9843972693; E-mail: drnikhilnanjappa@gmail.com
Received May 28, 2012; Accepted July 25, 2012; Published July 27, 2012
Citation: Nikhil Nanjappa BA, Alok Mohanty, Tirou Aroul T, Robinson Smile S,
Dhananjay Kotasthane (2012) Thyroid Carcinoma (Tc) in Nodular Goitre. Thyroid
Disorders Ther 1:115. doi:10.4172/2167-7948.1000115
Copyright: © 2012 Nikhil Nanjappa BA, et al. This is an open-access article
distributed under the terms of the Creative Commons Attribution License, which
permits unrestricted use, distribution, and reproduction in any medium, provided
the original author and source are credited.
Keywords: Nodular goitre; hyroid carcinoma; Papillary carcinoma
thyroid
Abbreviations: MNG: Multi-Nodular Goitre; STN: Solitary hyroid
Nodule; TC: hyroid Carcinoma; FNAC: Fine Needle Aspiration
Cytology; FNAB: Fine Needle Aspiration Biopsy
Background
he incidence of malignancy in MNG has been found to vary
from 4% to 17% [1]. hyroid carcinoma is a relatively rare tumour
but represents the most frequent form of endocrine cancer [2]. In
contradiction to earlier studies, the incidence of malignancy in STN
is not signiicantly higher than MNG [3]. hese studies alluded to the
fact that the risk of malignancy in both MNG and STN is not negligible.
herefore, both conditions should be carefully evaluated to detect
any underlying malignant foci, which may require further surgical
intervention [4]. his case series aims to study the incidence and
pathology of malignancy in patients operated for presumably benign
nodular thyroid disease.
Patients and Methods
A total of 175 patients who underwent surgery for presumably
benign nodular thyroid disease between January 2004 and March 2012
were studied, prospectively. hese patients underwent hemi, subtotal,
total thyroidectomy. Histopathology reports of these patients were
compiled, analysed and studied. he age and size diference between
benign and malignant nodular thyroid disease were analysed. he
incidence of malignancy was separately studied for MNG and STN. he
pathological variety of the malignancy in MNG and STN were studied.
Chi square test was used to calculate the statistical signiicance.
Results
Of the 175 patients who were operated for presumably benign
thyroid disease, 37 patients (21.1%) had malignancy reported on
histopathology examination (Table 1).
Abstract
Objective: To study the incidence and pathology of thyroid malignancy in patients operated for presumably
benign nodular thyroid disease (multi nodular goitre (MNG) & solitary thyroid nodule (STN)).
Methods: A total of 175 patients who underwent surgery for presumably benign nodular thyroid disease
between January 2004 and March 2012 were studied, prospectively. These patients underwent hemi, subtotal, total
thyroidectomy.
Results: 37 of the 175 patients (21%) had malignancy on inal histopathological examination. The mean age
of patients with benign disease was 46.4 years and that with malignancies was 50.6 years. Mean size of nodules
was 4.28 +/- 1.48 cm in the benign group and 4.21 +/- 1.48 cm in the malignant group. All those with MNG, 14/14
(100%) were papillary carcinoma and those with STN, 22/23 (95.7%) were papillary carcinoma. Among the papillary
carcinomas, follicular variant was 15 and the micropapillary variant was 3.
Conclusions: The incidence of malignancy in nodular goiter is higher than what is usually reported. There was
no signiicant difference in incidence of malignancy between MNG and STN (P value: 0.262). Papillary carcinoma
was signiicantly higher in nodular goiter (97.3%). Papillary carcinoma was found in all patients who presented with
MNG and all but one who presented with STN. Follicular variant of papillary carcinoma was more common than the
micropapillary variant (40.5% and 8.1% respectively).
he mean age of patients with nodular goitre was 47.4 years (SD:
15.05). Patients with benign goitres had a mean age of 46.4 years (SD:
15.21). he malignant goitres occur at an older age group, with a mean
age of 50.6 years (SD: 15.36).
Among the 175 patients, 160 (91.4%) were female. 77 presented
with MNG, of which 68 (88.3%) were female and 9 (11.7%) male. 12 of
68 females and 2 of the 9 males had TC. 98 patients presented as STN,
of which 92 (93.9%) were female and 6 (6.1%) male. 22 of the 92 females
and 1 of the 6 males had TC (Table 2).
Mean size of nodules was 4.28 +/- 1.48 cm in the benign group
and 4.21 +/- 1.48 cm in the malignant group. here were no signiicant
results observed.
Out of the 37 patients with thyroid carcinoma (TC), 23 (62.1%)
presented as STN and 14 (37.9%) as MNG on clinical examination. he
P value was 0.262 and was not signiicant.
PRE OP Diagnosis No. of patients (%) TC (%) P value
MNG 77 (44) 14 (37.8) 0.543
STN 98 (56) 23 (62.2) 0.262
TOTAL 175 (100) 37 (100) -
Table 1: Thyroid carcinoma in nodular thyroid disease.