The Prevalence of Thyroid Malignancy in Multinodular Goiter in Erbil Governorate
DOI:
https://doi.org/10.56056/amj.2018.70Keywords:
Fine needle aspiration cytology, Incidental thyroid carcinoma, Multinodular goiter, Total thyroidectomyAbstract
Background and objectives:thyroid malignancy is relatively a rare tumor, but it represents the most common form of malignancy of endocrine glands. The common scenario in multinodular goiter is finding of incidental thyroid carcinoma after histopathological evaluation of specimens for assumed benign thyroid lesions. The objective of the study was to estimate the prevalence and types of malignancy in multinodular goiter in Erbil governorate, in order to choose the best surgical options for their treatment.
Methods:This prospective cross-sectional study has been conducted from 1st March 2017 to 1st March 2018 on 72 patients with multinodular goiter in Rizgary teaching hospital and private hospitals in Erbil city. All patients evaluated preoperatively by history, clinical examination, thyroid function test, ultrasound study, fine needle aspiration cytology. Then, offered operative treatment for compressive symptoms, thyrotoxicosis, cosmetic concerns, undetermined cytology, suspicious or proved malignancy by fine needle aspirationcytology
Results: Among 72 cases, 90.3% were females and 9.7% were males, with mean age distribution at the time of surgery was 41.6 ± 12.6 years. 8.3% of patients found to have malignancy on final histological examination and papillar carcinoma constituted 83.3% of cases.
Conclusions:-we recommend near-total or total thyroidectomy to eliminate the need for re-operation in case of thyroid cancer.
Downloads
References
Teng W, Shan Z, Teng X, et al. Effect of iodine intake on thyroid diseases in China. N Engl J Med. 2006; 354(26):2783–93. Available from: http://scihub.cc/10.1056/nejmoa054022
Laurberg P, Jorgensen T, Perrild H, et al. The Danish investigation on iodine intake and thyroid disease, DanThyr: Status and perspectives. Eur J Endocrinol. 2006; 155(2):219–28.
Guth S, Theune U, Aberle J, Galach A, Bamberger C. Very high prevalence of thyroid nodules detected by high frequency (13 MHz) ultrasound examination. Eur JClin Invest. 2009; 39(8):699–706.
Ezzat S, Sarti D, Cain D, Braunstein G. Thyroid incidentalomas: Prevalence by palpation and ultrasonography. Arch Intern Med. 1994; 154(16):1838–40.
Kang H, No J, Chung J, et al. Prevalence, clinical and ultrasonographic characteristics of thyroid incidentalomas. Thyroid. 2004; 14(1):29–33. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15009911
Kilfoy B, Zheng T, Holford T, et al. International patterns and trends in thyroid cancer incidence, 1973-2002. Cancer Causes Control. 2009;20(5):525–31.
Frates M, Benson C, Charboneau J, et al. Management of thyroid nodules detected at US: Society of Radiologists in Ultrasound consensus conference statement. Ultrasound Quarterly. 2006. 22(4), 231-238.
Miccoli P, Minuto MN, Galleri D, et al. Incidental thyroid carcinoma in a large series of consecutive patients operated on for benign thyroid disease. ANZ J Surg. 2006; 76(3):123–6.
Lasithiotakis K, Grisbolaki E, Koutsomanolis D, et al. Indications for surgery and significance of unrecognized cancer in endemic multinodular goiter. World J Surg. 2012; 36(6):1286–92.
Slijepcevic N, Zivaljevic V, Marinkovic J, Sipetic S, Diklic A, Paunovic I. Retrospective evaluation of the incidental finding of 403 papillary thyroid microcarcinomas in 2466 patients undergoing thyroid surgery for presumed benign thyroid disease. BMC Cancer. 2015;15(1).
Abu-Eshy S, Khan A, Khan G, Al-Humaidi M, Al-Shehri M, Malatani T. Thyroid malignancy in multinodular goitre and solitary nodule., Journal of the Royal College of Surgeons of Edinburgh. 1995. 40: 310–2. Available from: http://www.ncbi.nlm.nih.gov/pubmed/8523308
Memon W, Khanzada TW, Samad A, Kumar B. Incidence of thyroid carcinoma in multinodular goiters. Rawal Med J. 2010; 35(1):65–7.
Gandolfi P, Frisina A, Raffa M et al. The incidence of Thyroid Carcinoma in Multinodular Goiter: retrospective analysis. Acta Bio Medica Atenei Parm. 2004; 75(2):114–7. [cited 2018 Feb 11].Available from: http://www.mattioli1885journals.com/index.php/actabiomedica/ article/view/2093/1611
Dogan L, Karaman N, Yilmaz K, Ozaslan C, Atalay C. Total thyroidectomy for the surgical treatment of multinodular goiter. Surg Today. 2011; 41(3):323–7.
Agarwal A, Agarwal S, Tewari P, et al. Clinicopathological profile, airway management, and outcome in huge multinodular goiters: An institutional experience from an endemic goiter region. World J Surg. 2012; 36(4):755–60.
Hoang J, Sosa J, Nguyen X , Galvin P, Oldan J. Imaging Thyroid Disease. Updates, Imaging Approach, and Management Pearls. Radiologic Clinics of North America. 2015;53:145–61.
Hurley D, Gharib H. Evaluation and management of multinodular goiter. Otolaryngol Clin North Am. 1996; 29(4):527–40. Available from: http://www.ncbi.nlm.nih.gov/pubmed/8844728
Zambudio A, Rodriguez J, Riquelme J, Soria T, Canteras M, Parrilla P. Prospective study of postoperative complications after total thyroidectomy for multinodular goiters by surgeons with experience in endocrine surgery. Ann Surg. 2004; 240(1):18–25. Available from: http://ovidsp.ovid.com/ovidweb.cgiT=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15213613
Krohn K, Führer D, Bayer Y et al. Molecular pathogenesis of euthyroid and toxic multinodular goiter, Endocrine Reviews. 2005; 26:504–24.
Ul Haq R, Khan B, Chaudhry I. Prevalence of malignancy in goitre--a review of 718 thyroidectomies. J Ayub Med Coll Abbottabad. 2009; 21(4):134–6. Available from: http://www.ncbi.nlm.nih.gov/ pubmed/21067046
Al-Yaarubi S, Farhan H, Al-Futaisi A, et al. Accuracy of ultrasound- guided fine-needle aspiration cytology for diagnosis of carcinoma in patients with multinodular goiter. Indian J Endocrinol Metab. 2011; 15(Suppl 2):S132-5. Available from: http://www.pubmedcentral.nih. gov/articlerender.fcgi?artid=3169873&tool=pmcentrez&rendertype=a bstract
Lin Y, Wu H, Yu M, Hsu C, Chao T. Patient outcomes following surgical management of multinodular goiter: Does multinodularity increase the risk of thyroid malignancy? Medicine (Baltimore). 2016;95(28):4194. [cited 2018 Feb 15]; Available from: http://www.ncbi.nlm.nih. gov/pubmed/27428220
Benzarti S, Miled I, Bassoumi T, et al. [Thyroid surgery (356 cases): risks and complications]. Rev Laryngol Otol Rhinol (Bord). 2002:123(1):33–7. [cited 2018 Mar 9]. Available from: http://www. ncbi.nlm.nih.gov/pubmed/12200998
Pradhan G, Shrestha R, Shrestha S, Neupane J, Bhattachan C. The incidence of thyroid carcinoma in multinodular goiter: prospective study. Nepal Med Coll J. 2011; 13(3):169–71. Available from: http:// www.ncbi.nlm.nih.gov/pubmed/22808807
Shrestha D, Shrestha S. The Incidence of Thyroid Carcinoma in Multinodular Goiter: A Retrospective Study. J Coll Med Sci. 2015; 10(4):18–21.[cited 2018 Mar 9]. Available from: http://www. nepjol.info/index.php/JCMSN/article/view/12974 26. Prades J, Dumollard J, Timoshenko A, et al. Multinodular goiter: surgical management and histopathological findings. Eur Arch Otorhinolaryngol. 2002; 259(4):217–21.
Luo J, McManus C, Chen H, Sippel R. Are there predictors of malignancy in patients with multinodular goiter? J Surg Res. 2012; 174(2):207–10.
Sachmechi I, Miller E, Varatharajah R, et al. Thyroid carcinoma in single cold nodules and in cold nodules of multinodular goiters. Endocr Pract. 2000; 6(1):5–7.
Koh K, Chang K. Carcinoma in multinodular goitre. Br J Surg. 1992;79(3):266–7.
Mathai V, Idikula J, Fenn AS, Nair A. Do long standing nodular goiters result in malignancies? Aust N Z J Surg. 1994; 64(3):180–2.
Botrugno I, Lovisetto F, Cobianchi L, et al. Incidental carcinoma in multinodular goiter: Risk factors. Am Surg. 2011; 77(11):1553–8.
Kaliszewski K, Struty ska-Karpi ska M, Zubkiewicz-Kucharska A, et al. Should the Prevalence of Incidental Thyroid Cancer Determine the Extent of Surgery in Multinodular Goiter? Chu P-Y, editor. PLoS One. 2016.; 11(12):e0168654.[cited 2018 Feb 15]. Available from: http:// dx.plos.org/10.1371/journal.pone.0168654
Laghari A, Baloch T, Memon G, Ghumro A, Shah S. Thyroid malignancy in multinodular goiter in our set up. Med Channel. 2013; 19(4):34–6.
Giles Y, Boztepe H, Terzio lu T, Tezelman S. The Advantage of Total Thyroidectomy to Avoid Reoperation for Incidental Thyroid Cancer in Multinodular Goiter. Arch Surg. 2004. 139(2):179. [cited 2018 Feb 11]. Available from: http://archsurg.jamanetwork.com/article. aspx?doi=10.1001/archsurg.139.2.179
Hardman J, Smith J, Nankivell P, Sharma N, Watkinson J. Re- operative thyroid surgery: A 20-year prospective cohort study at a tertiary referral centre. Eur Arch Oto-Rhino-Laryngology. 2015; 272(6):1503–8.
Barczy ski M, Konturek A, Hubalewska-Dydejczyk A, Go?kowski F, Nowak W. Ten-Year Follow-Up of a Randomized Clinical Trial of Total Thyroidectomy Versus Dunhill Operation Versus Bilateral Subtotal Thyroidectomy for Multinodular Non-toxic Goiter. World J Surg. 2018; 42(2):384–92.
Moalem J, Suh I, Duh QY. Treatment and prevention of recurrence of multinodular goiter: An evidence-based review of the literature. In: World Journal of Surgery. 2008;1301–12.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Banin Naser Muhamad, Sabah Jalal Shareef
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The copyright on any article published in AMJ (The Scientific Journal of Kurdistan Higher Council of Medical Specialties )is retained by the author(s) in agreement with the Creative Commons Attribution Non-Commercial ShareAlike License (CC BY-NC-SA 4.0)