Thyroid cancer and nodular goiter of thyroid: An analysis of patients in rural South Tamil Nadu

Johnsy Merla, Shantaraman Kalyanaraman

Thyroid Research and Practice 2017 14(3):106-111

Background: The aim of the study was to analyze the profile of nodular goiters of thyroid presenting with thyroid cancers in a tertiary hospital in rural South India. Materials and Methods: This study was conducted for 2 years since 2010 in patients with thyroid enlargements. Patients with multinodular or solitary thyroid enlargements with ultrasonogram suspicious of malignancy, fine-needle aspirate suspicious of malignancy, or persons with clinical suspicious thyroid enlargements with equivocal ultrasonogram or cytology with or without symptoms of mass effect were selected for the study. The clinical, operative, cytological, and histological data were tabulated and statistically analyzed. Results: Of 522 patients analyzed, 91.57% were females and 67.62% were between 21 and 40 years. Nearly 17.04% presented with hypothyroidism, 15.13% with hyperthyroidism, and 67.82% patients were euthyroid. Of the 522 patients, 425 (81.42%) had nodular thyroid enlargements, of whom 224 (42.91%) had multinodular goiters (MNGs), 201 (38.51%) had solitary thyroid nodules (SNT), and 97 (18.58%) had diffuse thyroid enlargements. The malignant tumors were present in 105 patients with papillary carcinoma, 20 patients with follicular carcinoma, and 6 with medullary carcinoma, of whom 76 (33.93%) had MNG and 54 (26.87%) had SNT. Conclusion: Thyroid cancers are best diagnosed through concerted clinical, radiological, cytological, and histological analyses. All nodules of thyroid, whether solitary or multinodular, should be sampled in fine-needle aspiration under radiological assistance and similarly all nodules need to be studied for malignancy in histopathology. In this study, we observed that the incidence rates of malignancy were higher than that of the existing Indian data and these patients were from the coastal regions of Tirunelveli and Thoothukudi districts. We also observed that multinodular goiters had microscopic malignant foci.

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