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High incidence of thyroid cancer in toxic multinodular goiters
Author(s) -
SHAIKH Irshad Ahammed,
MUTHUKUMARSAMY Girivasan,
VIDYADHARAN Ramesh,
ABRAHAM Santhosh John
Publication year - 2007
Publication title -
asia‐pacific journal of clinical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 29
eISSN - 1743-7563
pISSN - 1743-7555
DOI - 10.1111/j.1743-7563.2007.00108.x
Subject(s) - medicine , thyroid cancer , incidence (geometry) , thyroid , multinodular goiter , euthyroid , cancer , thyroidectomy , thyroid nodules , thyroid carcinoma , levothyroxine , gastroenterology , physics , optics
Aim: The aim of this study is to analyse the incidence of carcinoma thyroids in toxic multinodular goiters (MNG) and the pathological pattern of these cancer nodules. Methods: This is a retrospective review of 2344 patients, operated for MNG over a period of 10 years from January 1993 to December 2002 at Lourdes Hospital, Kochi, Kerala, India. Results: We operated on 2344 patients for MNG, out of whom 160 patients presented to us in a toxic state and the remaining 2184 in a non‐toxic state. Of the patients operated for MNG 4.5% were found to have associated thyroid cancer. The incidence of thyroid cancer in toxic MNG patients was 26.25% whereas in non‐toxic MNG patients it was 2.5%. All the malignant nodules detected were papillary cancers of the thyroid and relatively large nodules (range 0.6 cm−4.1 cm) were found in toxic MNG compared to non‐toxic MNG. Conclusion: Patients with toxic MNG showed a very high incidence of coexisting thyroid cancer. Thyroid cancers can coexist in toxic MNG despite the suppression of thyroid stimulating hormone (TSH). The coexisting thyroid cancer size is larger in toxic MNG than euthyroid MNG. A total thyroidectomy is the treatment recommended for toxic MNG in an endemic area.