In The Presence of Risk Factors High Rate of Incidental Multifocal Microcarcinoma Detection in Solitary Thyroid Nodule and Multinodular Goitre Justifies Total Thyroidectomy

Authors : Nevin Sakoğlu, Abdulkadir Asan

Pages : 510-521

Doi:10.5798/dicletip.1608094

View : 21 | Download : 46

Publication Date : 2024-12-27

Article Type : Research Paper

Abstract :Aim: Thyroid nodules are commonly encountered with increasing age. Majority of them are benign. In the present study, our goal was to identify both the false negative rate (FNR) of preoperative cytology, radiology results, risk factors for malignancy, and the prevalence of thyroid carcinoma in cases to whom operation performed for solitary thyroid nodule (STN) with multinodular goitre (MNG) and the final histopathological report. Methods: A retrospective study among 141 patients who were operated for suspicion of thyroid cancer between 2019-2022. 118 were women (83.6%) and 23 were men (16.3%). The mean age was 50.2(23.1). Demographic characteristics and factors predicting malignancy were questioned for all patients preoperatively. Preoperative ultrasonography (US), fine needle aspiration cytology (FNAc) results and postoperative histopathology data were collected. Ultrasound features (ACR-TIRADS), FNAc results, histopathology records, risk factors and malignancy rates was registered. Statistical analysis was done with Fisher\\\'s precision and Mann-Whitney U tests. Results: 141 patients underwent total thyroidectomy for STN (n=28, 19.8%) and MNG (n=113, 80.1%). The correlation of FNAc with final histopathology revealed that FNR in MNG was more often than that of STN (33.3% vs 66.6%, p<0.001). Malignancy was detected in 43 of 141 patients with total thyroidectomy due to STN and MNG (30.4%).Family history and previous radiotherapy were risk factors in patients with STN (25%). The histopathology results of 129 patients were compatible with ACR-TIRADS in ultrasound (91.4%). Conclusion: Although multinodular goiter (MNG) is generally believed to have a lower risk of malignancy compared to solitary thyroid nodules (STN), the prevalence of malignancy is significantly higher in STN and MNG. Optimal patient management depends on a good interaction between radiologist, pathologist and surgeon to decrease false negative and false positive cases.
Keywords : Cytology, solitary thyroid nodule, multinodular goitre, malignancy