Trends in symptomatology of thyroid malignancy in southern India and the efficacy of targeted fine needle aspiration cytology with ultrasonography guidance in diagnosis
DOI:
https://doi.org/10.18203/2349-2902.isj20194435Keywords:
Thyroid malignancy, Goitre, USG guided FNACAbstract
Background: Thyroid cancers are on the rise all over the world. Studies have shown a tripling incidence of thyroid cancer in the United States in the past 35 years. Similar studies from Korea have also shown similar trends of 15 times increase in incidence. This study aims at assessing the recent trends in clinical presentation of thyroid malignancy and the efficacy of ultrasound targeted fine needle aspiration cytology (FNAC) in the diagnosis of thyroid malignancy.
Methods: A cross sectional study was conducted involving 275 patients with thyroid disorders treated in the department of General Surgery at Dr. Somervell Memorial CSI Medical College, Trivandrum, India. Chi-square test was done for statistical test of significance and odds ratio for strength of association.
Results: In this study group, 89% of the patients presented with swelling in front of the neck as chief complaint both in benign and malignancy. Swelling in front of the neck is the predominant symptom in thyroid malignancy. 52% of patients presented with the described symptoms of more than 6 months duration. The specificity of USG guided FNAC is 90% in diagnosing malignancy in goitre in this study group.
Conclusions: The commonest symptom of thyroid malignancy was a painless swelling in the front of the neck. Most common thyroid pathology presenting as thyroid swelling was multinodular goitre. Nearly half of the patients presenting with symptoms more than 6 months had thyroid malignancy. FNAC under ultrasound guidance is an inexpensive accurate and practical investigation for evaluation of thyroid carcinomas.
References
Kitahara CM, Sosa JA. The changing incidence of thyroid cancer. Nat Rev Endocrinol. 2016;12(11):646-53.
Davies L, Welch HG. Current thyroid cancer trends in the United States. JAMA Otolaryngol Head Neck Surg. 2014;140(4):317-22.
Ahn HS, Kim HJ, Welch HG. Korea’s thyroid-cancer “epidemic”-screening and overdiagnosis. N Engl J Med. 2014;371(19):1765-7.
Hedinger C, Williams ED, Sobin LH. Histological typing of thyroid tumours: WHO international classification of tumours. 4th ed. Berlin: Springer-Verlag; 1998.
Kwak JY, Han KH, Yoon JH . Thyroid imaging reporting and data system for US features of nodules: a step in establishing better stratification of cancer risk. Radiol. 2011;260(3):892-9.
Horvath E, Majlis S, Rossi R. An ultrasonogram reporting system for thyroid nodules stratifying cancer risk for clinical management. J Clin. Endocrinol Metab. 2009;94 (5):1748-51.
In: Brunicardi FC, Anderson DK, Billiar TR, Dunn DL, Hunter JG, Mathews JB, eds. Schwartz principle of surgery. 9th ed. McGraw Hill; 2010: 2950-2965.
Thomas WEG. Neoplasm’s of thyroid gland (including the solitary nodule). Surg Int. 2004;64:296-300.
Holzer S, Reiners C, Mann K, Bamberg M, Rothmund M, Dudeck J, et al. Patterns of care for patients with primary differentiated carcinoma of the thyroid gland treated in Germany during 1996. U.S. and German Thyroid Cancer Group. Cancer J. 2000;89:192-201.
Rahman M, Ali MI, Karim A, Arafat S, Hanif M, Tarafder KH. Frequency of malignancy in multinodular goitre. Bangladeh J Otorhinolaryngol. 2014;20(2)75-9.
Ocak S, Akten AO, Tez M. Thyroid cancer in hyperthyroid patients: is it different clinical entity? Endocr Regul. 2014;48:65-8.
Dorairajan N, Pandiarajan R, Yuvaraja S. A descriptive study of papillary thyroid carcinoma. Asian J Surg. 2002;25(4):300-3.