Publication:

Incidence of malignancy among thyroid swellings

Background Thyroid swellings are common in clinical practice, with most being benign, although a small but significant proportion may harbor malignancy. Therefore, this study was conducted to determine the incidence of malignancy among thyroid swellings in a tertiary care hospital setting.

Methods This observational cross-sectional study was conducted at the Department of ENT and Head-Neck Surgery, Rajshahi Medical College Hospital, Rajshahi, Bangladesh, from June to December 2014. Fifty patients with clinically and sonographically diagnosed thyroid swellings undergoing thyroidectomy were included to determine the incidence of malignancy. All patients were evaluated clinically and investigated with FNAC, thyroid function tests and ultrasonography, with histopathology confirming the final diagnosis.

Results Among 50 patients, most were aged 31–40 years (40.0%), with females 84.0% (F:M=5.25:1) and middle class 70.0%. Neck swelling was present in 100%, with dysphagia 8.0%, pain 6.0%, dyspnoea 2.0% and lymphadenopathy 2.0%. Most presented within 6 months–2 years (48.0%). Solid nodules were 70.0% and multinodular goitre 68.0%. FNAC showed colloid goitre 76.0%, with malignancy 14.0% (7 cases). Papillary carcinoma accounted for 85.7%, with metastasis 14.3%. Hemithyroidectomy was most common (60.0%), followed by total thyroidectomy (22.0%).

Conclusions Thyroid swellings show a 14.0% incidence of malignancy, higher in males and extreme age groups, with papillary carcinoma being the most common type.