Rising incidence of malignancy in thyroid nodule: a clinico radio pathological evaluation
DOI:
https://doi.org/10.18203/issn.2454-5929.ijohns20232217Keywords:
Solitary thyroid nodule, Hemithyroidectomy, TBSRTC, TIRADS, MalignancyAbstract
Background: Thyroid nodules are a common endocrine problem with varied aetiology and presentation. Benign nodules also need to be evaluated in detail for possibility of malignancy in today’s era of rising incidence of malignancy. This study aims to comparatively analyse and verify the incidence of malignancy reported in tertiary care hospital with incidence of malignancy published in standard journals and research. The study also endeavours to clinically examine solitary thyroid nodules in patients admitted to the tertiary care centre.
Methods: A retrospective study was carried out from 2019 to 2022, in the Department of ENT, in a Tertiary Care Hospital. Thirty patients, with solitary thyroid nodule, were clinically examined and investigated using ultrasonography and Fine Needle Aspiration Cytology, before undergoing hemi/total thyroidectomy. The histopathological reports and pre-operative investigations were analysed by standard statistical methods.
Results: Clinically detected solitary thyroid nodule turned out to be malignant in 30% of studied cases with preponderance of papillary carcinoma. This figure is significantly higher than most of the previous data published in standard journals. A rare case of cystic presentation of anaplastic thyroid carcinoma was also studied.
Conclusions: It is concluded from the present study that incidence of malignancy has shown sharp rise- from the published average of 19-21 percent to 30 percent in the present case. The study also infers that there is female preponderance in thyroid swellings. The mean age of solitary thyroid nodule is 35 years i.e., between 30 to 40 years.
References
Krukowski ZH. The thyroid and the thyroglossal tract, Bailey and Love’s short practice of Surgery. 24th ed. USA: Springer; 2009:771.
Cole WH, Majarakis JD. Incidence of carcinoma of the thyroid in nodular goitre. J Clin Endocrinol. 1949;9: 1007-11.
Vander JB, Gaston EA, Dauber TR. The significance of non-toxic thyroid nodules. Final report of 15 years study of incidence of thyroid malignancy. Ann Intern Med. 1968;537-40.
Ezzat S, Sarti DA, Cain DR. Braunstein GD. Thyroid incidentalomas, prevalence by palpation and ultrasonography. Arch Intern Med. 1994;154:1838-40.
Maddox PR, Malcolm H, Wheeler MD. Approach to thyroid nodules. Textbook of Endocrine Surgery. Philadelphia: WB Saunders; 1997:688.
Mazzaferri EL. Management of solitary thyroid nodule. N Engl J Med. 1993;328:553-9.
Hoang JK, Langer JE, Middleton WD, Wu CC, Hammers LW, Cronan JJ, et al. Managing incidental thyroid nodules detected on imaging: white paper of the ACR Incidental Thyroid Findings Committee. J Am Radiol. 2015;12(2):143-50.
Cibas ES. The bethesda system for reporting thyroid cytopathology. Am J Clin Pathol. 2009;132:658-65.
Anitha S, Ravimohan TR. A study of incidence of malignancy in solitary nodule of thyroid. Int J Contemp Med Res. 2016;3(4):993-5.
Sabu N. Satihal solitary thyroid nodule: efficacy of FNAC in diagnosing malignancy and various surgical modalities in management. Int J Recent Trends Sci Technol. 2014;10(2):28-32.
Palani V, Reshma S. A clinical study of incidence of malignancy in solitary thyroid nodule in a tertiary care hospital. Int Surg J. 2019;6:293-5.
Babu SBK, Raju R, Radhakrishnan S. Correlation of fine needle aspiration cytology with histopathology in the diagnosis of thyroid swellings. Int Surg J. 2016;3: 1437-41.
Wong KS, Jo VY, Lowe AC, Faquin WC, Renshaw AA, Shah AA, et al. Malignancy risk for solitary and multiple nodules in Hürthle cell-predominant thyroid fine-needle aspirations: A multi-institutional study. Cancer Cytopathol. 2020;128(1):68-75.
Singh P, Gupta N, Dass A, Handa U, Singhal SK. Correlation of fine needle aspiration cytology with histopathology in patients undergoing thyroid surgery. Otolaryngol Pol. 2021;75(4):33-9.
Orlo H, Clark, Nadine R. Caron, Thyroid disorders. In: Mastery of Surgery. Netherlands: Elsevier; 5th ed. 2015.
Sangalli G, Serio G, Zampatti C, Bellotti M, Lomuscio G. Fine needle aspiration cytology of the thyroid: a comparison of 5469 cytological and final histological diagnoses. Cytopathology. 2006;17(5):245-50.
Srinivas P, Kampelly S, Gottumukkala A. Clinical Study on Management of Multinodular Goitre. JMSCR. 2017;5(5):222-8.
Hemashankara BR, Chakravarthy A. Study of incidence in between benign and malignant tumors of solitary thyroid nodule. Int J Res Med Sci. 2016;4(12): 5290.
Karthiyayini T, Sridhar SK. A clinical study of incidence of malignancy in solitary nodule of thyroid. Sch J App Med Sci. 2017;5(5):1888-91.