Thyroid Malignancy in Long Standing Multinodular Goitre: A Case Series with Review of Literature
Keywords:
Thyroid malignancy, longstanding multinodular goitre, review of literature
Abstract
Clinical presentation of patients with multinodular goitre is variable. Fine-needle aspiration (FNA) has been widely accepted as an initial step in the management of thyroid nodules. However, the usefulness of FNA to assess the risk of malignancy in thyroid nodules occurring within a long standing multinodular goitre (MNG) has not been completely clarified. Moreover, an unresolved issue is whether MNG is significantly associated with malignancy. MNG had been traditionally thought to be at a low risk for malignancy as compared to a solitary thyroid nodule (STN). However, review of literature showed no statistical difference in incidence of malignancy in both MNG and solitary nodular goitre. The incidence of malignancy in multinodular goitres has been found to vary from 7.5% to 17%. The duration of the associated goitre varies and ranges from the shortest of one month to the longest of more than 20 years. Considering this background, we are reporting a series of three cases of thyroid malignancies diagnosed on FNAC in patients having long standing goitre.References
1. M Salih Deveci, Güzin Deveci, Virginia A LiVolsi, and Zubair W Baloch. Fine-needle aspiration of follicular lesions of the thyroid. Diagnosis and follow-Up. Cytojournal. 2006;3:9.
2. Nguyen GK, Lee MW, Ginsberg J, Wragg T, Bilodeau D. Fine-needle aspiration of the thyroid: an overview. Cytojournal. 2005;2:12.
3. Mazzaferri EL. Management of a solitary thyroid nodule. N Engl J Med 1993;328:553-9.
4. Frates MC, Benson CB, Doubilet PM, Kuneuther E, Conterase M, Cibas ES, et al. Prevalence and distribution of carcinoma in patients with solitary thyroid nodules on sonography . J ClinEndocrinol. Metab. 2006;91:3411-7.
5. Franklyn JA, Daykin J, Young J, Oates G D, Sheppard M C. Fine needle aspiration cytology in diffuse multinodular goiter compared to solitary thyroid nodules. BMJ 1993;307:240.
6. Nadeem K, Akhtar N, Tarar JM. Thyroid malignancy in multi nodular goiter; incidence, a retrospective study in southern punjab. Professional Med J 2013;20:587-590.
7. K. Sothy, M. Mafauzy, W.B. Wan Mohamad, B.E. Mustaffa. Carcinoma of thyroid - clinical presentation and outcome. Med. J. Malaysia. 1991;46.
8. Tollin SR, Mery GM, Jelveh N, Fallon EF, Mikhail M, Blumenfeld W, Perlmutter S. The use of fine-needle aspiration biopsy under ultrasound guidance to assess the risk of malignancy in patients with a multinodular goiter. Thyroid. 2000;10:235–241.
9. McCall A, Jarosz H, Lawrence AM, Paloyan E. The incidence of thyroid carcinoma in solitary cold nodules and in multinodular goiters. Surgery. 1986;100:1128-1132.
10. Hanumanthappa. M.B, Gopinathan S, Rithin Suvarna, Guruprasad Rai D, Gautham Shetty, Ashith Shetty, et al. The Incidence of Malignancy in Multi-nodular Goitre: A Prospective Study at a Tertiary Academic Centre. Journal of Clinical and Diagnostic Research. 2012;6:267-270.
11. Papini E, Guglielmi R, Bianchini A, Crescenzi A, Taccogna S, Nardi F et al. Risk of malignancy in nonpalpable thyroid nodules: predictive value of ultrasound and color-Doppler features. J Clin Endocrinol Metab. 2002;87:1941-6.
12. Ríos A, Rodríguez JM, Galindo PJ, Montoya M, Tebar FJ, Sola J et al. Utility of fine-needle aspiration for diagnosis of carcinoma associated with multinodular goitre. Clin Endocrinol. 2004;61:732-7.
13. Kojić Katović S, Halbauer M, Tomić-Brzac H. Importance of FNAC in the detection of tumours within multinodular goitre of the thyroid. Cytopathology. 2004;15:206-11.
14. Mathai V, Idikula J, Fenn AS, Nair A. Do long-standing nodular goitres result in malignancies? Aust N Z J Surg. 1994;64:180–2.
15. Erbil Y, Barbaros U, Salmaslioglu A, Mete O, Issever H, Ozarmagan S, et al. Effect of thyroid gland volume in preoperative detection of suspected malignant thyroid nodules in a multinodular goiter. Arch Surg. 2008;143:558–63.
16. Nadir Paksoy, Kadri Yazal and Selin Çorak. Malignancy rate in non- dominant nodules in patients with multinodular goiter: Experience with 1,606 cases evaluated by ultrasound-guided fine needle aspiration cytology. Cytojournal. 2011;8:19.
17. Subhash CB, Manoj KS, Abhisheik MS, Subhabrata D, Ranjit B, Anower HH. Evaluation Of Incidence Of Malignancy In Multinodular Goitre. Journal of Evolution Medical and Dental Sciences. 2014;3:165-172.
2. Nguyen GK, Lee MW, Ginsberg J, Wragg T, Bilodeau D. Fine-needle aspiration of the thyroid: an overview. Cytojournal. 2005;2:12.
3. Mazzaferri EL. Management of a solitary thyroid nodule. N Engl J Med 1993;328:553-9.
4. Frates MC, Benson CB, Doubilet PM, Kuneuther E, Conterase M, Cibas ES, et al. Prevalence and distribution of carcinoma in patients with solitary thyroid nodules on sonography . J ClinEndocrinol. Metab. 2006;91:3411-7.
5. Franklyn JA, Daykin J, Young J, Oates G D, Sheppard M C. Fine needle aspiration cytology in diffuse multinodular goiter compared to solitary thyroid nodules. BMJ 1993;307:240.
6. Nadeem K, Akhtar N, Tarar JM. Thyroid malignancy in multi nodular goiter; incidence, a retrospective study in southern punjab. Professional Med J 2013;20:587-590.
7. K. Sothy, M. Mafauzy, W.B. Wan Mohamad, B.E. Mustaffa. Carcinoma of thyroid - clinical presentation and outcome. Med. J. Malaysia. 1991;46.
8. Tollin SR, Mery GM, Jelveh N, Fallon EF, Mikhail M, Blumenfeld W, Perlmutter S. The use of fine-needle aspiration biopsy under ultrasound guidance to assess the risk of malignancy in patients with a multinodular goiter. Thyroid. 2000;10:235–241.
9. McCall A, Jarosz H, Lawrence AM, Paloyan E. The incidence of thyroid carcinoma in solitary cold nodules and in multinodular goiters. Surgery. 1986;100:1128-1132.
10. Hanumanthappa. M.B, Gopinathan S, Rithin Suvarna, Guruprasad Rai D, Gautham Shetty, Ashith Shetty, et al. The Incidence of Malignancy in Multi-nodular Goitre: A Prospective Study at a Tertiary Academic Centre. Journal of Clinical and Diagnostic Research. 2012;6:267-270.
11. Papini E, Guglielmi R, Bianchini A, Crescenzi A, Taccogna S, Nardi F et al. Risk of malignancy in nonpalpable thyroid nodules: predictive value of ultrasound and color-Doppler features. J Clin Endocrinol Metab. 2002;87:1941-6.
12. Ríos A, Rodríguez JM, Galindo PJ, Montoya M, Tebar FJ, Sola J et al. Utility of fine-needle aspiration for diagnosis of carcinoma associated with multinodular goitre. Clin Endocrinol. 2004;61:732-7.
13. Kojić Katović S, Halbauer M, Tomić-Brzac H. Importance of FNAC in the detection of tumours within multinodular goitre of the thyroid. Cytopathology. 2004;15:206-11.
14. Mathai V, Idikula J, Fenn AS, Nair A. Do long-standing nodular goitres result in malignancies? Aust N Z J Surg. 1994;64:180–2.
15. Erbil Y, Barbaros U, Salmaslioglu A, Mete O, Issever H, Ozarmagan S, et al. Effect of thyroid gland volume in preoperative detection of suspected malignant thyroid nodules in a multinodular goiter. Arch Surg. 2008;143:558–63.
16. Nadir Paksoy, Kadri Yazal and Selin Çorak. Malignancy rate in non- dominant nodules in patients with multinodular goiter: Experience with 1,606 cases evaluated by ultrasound-guided fine needle aspiration cytology. Cytojournal. 2011;8:19.
17. Subhash CB, Manoj KS, Abhisheik MS, Subhabrata D, Ranjit B, Anower HH. Evaluation Of Incidence Of Malignancy In Multinodular Goitre. Journal of Evolution Medical and Dental Sciences. 2014;3:165-172.
Published
2020-05-28
Issue
Section
Case Report
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