The incidence of thyroid malignancy in multinodulargoiter in Alkindy teaching hospital.

Abstract

Back ground: The incidence of malignancy in multi-nodular goiter is thought to be low as compared with solitary thyroid nodule.
Objectives: Identifying incidence of malignancy in multi-nodular goiter.
Patients and Methods: This is a prospective study at Al-kindy teaching hospital from January 2013 to September 2015. 160 patient with multi-nodular goiter were included in the study (132females,28 males)  their ages ranged between 17-75 years with a mean age of 35.88 years. Each of the patients had special form of detailed information including history and physical examination ,results of investigations; all the patients had near total thyroidectomy. All the specimens were fixed in formalin and sent for histo-pathological evaluation.
Results: Females affected by multi-nodular goiter more than males (132 females&28 males) with a ratio of 4.7/1 female to male ; 36.25 % of them were in the 4th decade of life ; the most common presenting symptom was mass in the neck (51.8 %) ; nodules affect both lobes +\- isthmus in 85.6% of the patients ; FNAC(fine needle aspiration cytology) in suspected nodules show atypical cells in 18% of the patients ; the pathological cause of multi-nodular goiter was thyroid tumor in 30 patient(18.7%) , (16 patient) by adenoma( 53.3%) and (14 patient) by malignancy (46.7%) ; the most common malignant tumor was papillary carcinoma in 85.7% followed by follicular carcinoma in 14.3%.
Conclusion: The incidence of malignancy is quite high 8.7% in multi-nodular goiter patient which makes
near total thyroidectomy as preferable procedure in the treatment of the disease.