World Journal of Endocrine Surgery

Register      Login

VOLUME 10 , ISSUE 3 ( September-December, 2018 ) > List of Articles

ORIGINAL ARTICLE

Incidental Thyroid Carcinoma in Benign Thyroid Disease: A Cohort Study

Ranil Fernando, Diluka Pinto, Nalinda Munasinghe, Pramod C Chandrasinghe

Keywords : Goiter, Thyroid cancer, Thyroid carcinoma, Thyroid surgery, Thyroidectomy

Citation Information : Fernando R, Pinto D, Munasinghe N, Chandrasinghe PC. Incidental Thyroid Carcinoma in Benign Thyroid Disease: A Cohort Study. World J Endoc Surg 2018; 10 (3):154-156.

DOI: 10.5005/jp-journals-10002-1238

License: CC BY-NC 4.0

Published Online: 01-12-2018

Copyright Statement:  Copyright © 2018 Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim: An incidental thyroid carcinoma (ITC) is a thyroid malignancy that is not clinically or cytologically detected preoperatively. The incidence of ITC is between 10% to 20% in the literature. A study was undertaken to assess the incidence of ITC in patients undergoing total thyroidectomy for benign disease of the thyroid to University Surgical Unit, North Colombo Teaching Hospital (NCTH), Sri Lanka. Materials and methods: Prospective cohort study was undertaken from November, 2002 to October, 2015. Patients with palpable thyroid nodules were assessed with fine needle aspiration cytology (FNAC) and ultrasound scan (USS) to ascertain benign thyroid disease (BTD). Hormone assays were conducted to detect thyroid status. All patients with BTD who underwent total thyroidectomy were included in the study. Histopathological assessments were made by a panel of pathologists. Patients with autoimmune thyroiditis (AIT) were excluded due to the known association with malignancy of the thyroid. Post-thyroidectomy histopathological diagnoses were collected prospectively and patients with ITC were identified. Statistical analysis was done using statistical package for the social sciences (SPSS) software, version 20. Results: Hundred and sixty seven patients (n = 167) who fulfilled the inclusion criteria were analysed (Male–20, female–147, median age = 40.25 year, range 28 year–62 year). ITC was found in 19 patients with an incidence of 11.38%. No significant association was noted with morphology, biochemical status of the thyroid or gender. Conclusion: Incidence of ITC is 11.38% in this cohort. Incidence of ITC being approximately 1:10 emphasizes the need to consider total thyroidectomy in the management of BTD.


PDF Share
  1. Klinck GH, Winship T. Occult sclerosing carcinoma of the thyroid. Cancer. 1955;8(4):701-706.
  2. Fernando P, Ratnatunga C, Fernando R, Lowe D, Udugama C, Wattegama S. Management of Goitre [Internet]. 1st ed. Sri lanka: College of Surgeons Sri Lanka; 2007 [cited 3 July 2017]. Available from: http://http://www.slcog.lk/img/guidelines/Other%20national%20Gidelines/Surgeons/Book%201/Management%20of%20Goitre.pdf
  3. Koutelidakis I, Laskou S, Kapoulas S, Kalaitzis S, Papadakis G, Evangelatos P, et al. Incidental thyroid cancer in patients undergoing total thyroidectomy for benign disease. Hellenic Journal of Surgery. 2015 Jul 1;87(4):307-8.
  4. Nanjappa N, Kumar A, Swain SK, Aroul TT, Smile SR, Kotasthane D. Incidental thyroid carcinoma. Indian Journal of Otolaryngology and Head & Neck Surgery. 2013 Jan 1;65(1):37-39.
  5. Fernando R, Mettananda DS, Kariyakarawana L. Incidental occult carcinomas in total thyroidectomy for benign diseases of the thyroid. Ceylon Medical Journal. 2009 Apr 21;54(1): 4-6.
  6. Azizi G, Keller JM, Lewis M, Piper K, Puett D, Rivenbark KM, et al. Association of Hashimoto's thyroiditis with thyroid cancer. Endocrine-related cancer. 2014 Dec 1;21(6):845-852.
  7. Russell S. Treatment-seeking behaviour in urban Sri Lanka: trusting the state, trusting private providers. Social science & medicine. 2005 Oct 31;61(7):1396-1407.
  8. Fernando R, Pathmeswaran A, Pinto MD. Epidemiology of goitre in Sri Lanka in the post-iodization era. Ceylon Medical Journal. 2015;60(2):41-44.
  9. Miccoli P, Minuto MN, Galleri D, D'Agostino J, Basolo F, Antonangeli L, et al. Incidental thyroid carcinoma in a large series of consecutive patients operated on for benign thyroid disease. ANZ journal of surgery. 2006 Mar 1;76(3):123- 126.
  10. Negro R, Valcavi R, Toulis K. Incidental thyroid cancer in toxic and nontoxic goiter: is TSH associated with malignany rate? Results of a meta-analysis. Endocrine Practice. 2012 Nov 27;19(2):212-218.
  11. Boucek J, Kastner J, Skrivan J, Grosso E, Gibelli B, Giugliano G, et al. Occult thyroid carcinoma. Acta Otorhinolaryngologica Italica. 2009 Dec;29(6):296.
  12. Jabbar MQ, CABMS MD, Mutlak NS, Hussein WA, Sulaiman TI, CABMS FF. Incidental thyroid carcinoma.
  13. Reeve TS, Delbridge L, Cohen A, Crummer P. Total thyroidectomy. The preferred option for multinodular goiter. Annals of surgery. 1987 Dec;206(6):782.
  14. Friguglietti CU, Lin CS, Kulcsar MA. Total thyroidectomy for benign thyroid disease. The Laryngoscope. 2003 Oct 1;113(10):1820-1826.
  15. Colak T, Akca T, Kanik A, Yapici D, Aydin S. Total versus subtotal thyroidectomy for the management of benign multinodular goiter in an endemic region. ANZ journal of surgery. 2004 Nov 1;74(11):974-978.
  16. Barakate MS, Agarwal G, Reeve TS, Barraclough B, Robinson B, Delbridge LW. Total thyroidectomy is now the preferred option for the surgical management of Graves’ disease. ANZ journal of surgery. 2002 May 1;72(5):321-324.
  17. Zuberi LM, Yawar A, Islam N, Jabbar A. Clinical presentation of thyroid cancer patients in Pakistan-AKUH experience. Journal-Pakistan Medical Association. 2004 Oct;54(10):526- 527.
  18. Mathai V, Idikula J, Fenn AS, Nair A. Do Long Standing Nodular Goitres Result in Malignancies?. ANZ Journal of Surgery. 1994 Mar 1;64(3):180-182.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.