The risk of thyroid carcinoma in multinodular goiter compared to solitary thyroid nodules: A retrospective analysis of 600 patients |
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| Affiliation: | 1. Consultant (Surgery), King Hussein Medical Center, Amman 11831, Jordan;2. Senior Specialist (Pathology), King Hussein Medical Center, Amman 11831, Jordan;3. Specialist (Surgery), King Hussein Medical Center, Amman 11831, Jordan;4. Senior Specialist (Internal Medicine and Endocrinology), King Hussein Medical Center, Amman 11831, Jordan;5. Senior Resident (Surgery), King Hussein Medical Center, Amman 11831, Jordan;6. Senior Specialist (Surgery), King Hussein Medical Center, Amman 11831, Jordan;1. Classified Specialist (Respiratory Medicine), Military Hospital (Cardio Thoracic Centre), Pune 411040, India;2. Graded Specialist (Radiology), Command Hospital (Southern Command), Pune 411040, India;3. Senior Advisor (Medicine & Respiratory Medicine) & Head, Military Hospital (Cardio Thoracic Centre), Pune 411040, India;4. Consultant (Medicine & Respiratory Medicine) & Head, Army Hospital (R&R), Delhi 110010, India;1. Resident, Department of Pediatrics, Armed Forces Medical College, Pune 411040, India;2. Associate Professor (Pediatrics & Pediatric Nephrology), Department of Pediatrics, Armed Forces Medical College, Pune 411040, India;3. Associate Professor (Pediatrics & Pediatric Intensive Care), Department of Pediatrics, Armed Forces Medical College, Pune 411040, India;4. Classified Specialist (Pediatrics and Pediatric Nephrology), Command Hospital (Southern Command), Pune 411040, India;5. Associate Professor, Department of Community Medicine, Armed Forces Medical College, Pune 411040, India;6. Dean & Deputy Commandant, Armed Forces Medical College, Pune 411040, India;1. Senior Advisor (Nephrology), Army Hospital (Research & Referral), Delhi, India;2. Senior Resident (Nephrology), Army Hospital (Research & Referral), Delhi, India;3. Classified Specialist, (Nephrology), Army Hospital (Research & Referral), Delhi, India;1. Senior Advisor (Radiotherapy) & Head, Radiotherapy Centre, Command Hospital (Air Force), Bengaluru 560007, India;2. Medical Physicist, Radiation Oncology Centre, INHS Asvini, Colaba, Mumbai 400005, India;3. Graded Specialist (Radiotherapy) and Head, Radiation Oncology Centre, INHS Asvini, Colaba, Mumbai 400005, India;4. Commanding Officer, INHS Sanjeevani, Kochi, India;5. Senior Advisor (Radiodiagnosis), Command Hospital (Air Force), Bengaluru 560007, India;1. Department of General Surgery, Prince Hashem Bin Abdullah II, Jordan;2. Department of Anesthesia and Intensive Care, King Husain Medical Center, Jordan |
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| Abstract: | BackgroundIt is generally believed that multinodular goiter (MNG) is associated with a lower risk of malignancy compared to solitary thyroid nodules (STN). This will be the null hypothesis in this retrospective study and we aim to prove or reject it.MethodsMedical files and histopathology reports of 600 patients who underwent thyroidectomy over 4-year period were reviewed. Data including patient’ age, gender, presentation, ultrasonography, FNAC, surgical procedures, final histopathologic diagnosis and stage of malignant tumors were collected and analyzed. The primary end point was assessment of risk of thyroid carcinoma in patients with MNG compared to those with STN. Secondary endpoints included demographic differences and prognosis.ResultsThere were 459 females (76.5%). Mean age was 44.3 ± 14.5 years (range 14–85). After exclusion of 33 patients, 224 (39.5%) had STN and 343 (60.5%) had MNG. The prevalence of thyroid cancer was 41.1% (92/224) in STN compared to 29.2% (100/343) in MNG (Chi-Square = 8.593, p < 0.01). However, on multiple logistic regression analysis this correlation was found insignificant (p = 0.640). Only male gender (p = <0.000005) and preoperative impression of malignancy (p = 0.000082) were significantly associated with thyroid carcinoma.ConclusionThe risk of thyroid carcinoma in STN and MNG was similar. Male gender was identified as a risk factor for thyroid cancer while age, number and size of nodules were not. |
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| Keywords: | Multinodular goiter Solitary thyroid nodule Thyroid cancer |
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