FREQUENCY AND HISTOPATHOLOGICAL EVALUATION OF MALIGNANCIES IN MULTINODULAR GOITER

Abstract Objective:   To determine the frequency and types of various malignancies in patients presented with multi-nodular goiter (MNG). Study Design:  Observational prospective study. Place and duration:   Conducted in the departments of Pathology and Surgery, Peoples University of Naqvi S.Q.H. 1 Associate Professor, Department of Pathology Peoples University of Medical and Health Sciences, Nawabshah Arijia D. 2 Assistant Professor of Surgery Ghulam Muhammad Mahar Medical College, Sukkur Arshad S. 3 Consultant Department of Surgery Ghulam Muhammad Mahar Medical College, Sukkur Memon J.M. 4 Professor and Head of Department Surgery Ghulam Muhammad Mahar Medical College, Sukkur Memon M.R. 5 Professor of Surgery Ghulam Muhammad Mahar Medical College, Sukkur Bozdar A.G. 6 Associate Professor of Surgery Ghulam Muhammad Mahar Medical College, Sukkur 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 pro-forma. Pre-operative fine needle aspiration cytology (FNAC) was performed of any dominant nodule which was suspicious on ultrasound examination. Serum TSH, FT 3 and FT 4 levels were also evaluated to deter-mine the toxic status of the patient. The patients were underwent total thyroidectomy and the resected speci-mens were sent in formalin for histopathological exa-mination, 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 2 nd to 4 th decades of their life. All (144) of the cases were having major complain of swelling in front of neck of various duration. On histological exa-mination 132 (91.7%) were benign and diagnosed as MNG, while 12 (8.3 %) cases were diagnosed as mali-gnant lesion. The malignant lesion consists of papil-lary carcinoma in 09 (75%) cases. Follicular carci-noma 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 fema-les. The papillary carcinoma was the dominant variant. Key Words:   MNG, Throidectomy, Malignancy, Papi-llary Carcinoma.