FREQUENCY AND HISTOPATHOLOGICAL EVALUATION OF MALIGNANCIES IN MULTINODULAR GOITER

Objective: To determine the frequency and types of various malignancies in patients presented with multinodular goiter (MNG). Study Design: Observational Prospective study. Place and Duration: Conducted in the departments of Pathology and Surgery, Peoples University of Medical and Health Sciences (PUMHS) Nawabshah, department of Surgery Ghulam Muhammad Mahar Medical College Hospital Sukkur, cases were also collected from the private clinics. Duration: January 2008 June 2013. Patients and Methods: All adult patients irrespective of sex were recruited presented during the study period with MNG on clinical examination or on ultrasound of neck. The demographic data was collected on a proforma. Pre-operative fine needle aspiration cytology (FNAC) was performed of any dominant nodule which was suspicious on ultrasound examination. Serum TSH, FT3 and FT4 levels were also evaluated to determine the toxic status of the patient. The patients were underwent total thyroidectomy and the resected specimens were sent in formalin for histopathological examination, and after collection of reports the results were tabulated. Results: In current study 144 patients having aged between 18 – 63 years were analyzed, including 18 (12.5%) male and 126 (87.5%) female. The male to female ratio was 1:7. The majority of patients were presented in 2nd to 4th decades of their life. All (144) of the cases were having major complain of swelling in front of neck of various duration. On histological examination 132 (91.7%) were benign and diagnosed as MNG, while 12 (8.3 %) cases were diagnosed as malignant lesion. The malignant lesion consists of papillary carcinoma in 09 (75%) cases. Follicular carcinoma was detected in 02 (16.7%) cases and madullary carcinoma was diagnosed in one case. Conclusion: The current study highlights the risk of malignancy in multinodular goiter. The frequency of malignancy in MNG was 8.3% present more in females. The papillary carcinoma was the dominant variant.