Abstract
Objective: To determine the complications associated various types of tumors of advanced stage of thyroid disease at tertiary care hospital.
 Study Design: Descriptive study.
 Place and Duration: Two years study from April 2018 to March 2020 was conducted in Liaquat University of Medical and health sciences Jamshoro.
 Patients and Methods: All patients were admitted from Outpatient department (OPD) with advance stage of tumor of thyroid and either of gender were included. The patients were evaluated fully after history and clinical examinations berries sign and specific investigations of thyroid profile (T3,T4,TSH), ultrasound of thyroid, fine-needle aspiration cytology FNAC, image guided biopsy, frozen section biopsy for confirmation of diagnosis, indirect laryngoscopy, x - Ray neck and MRI. All the patients were assessed for pre-operative evaluation (complications) with advanced stage of thyroid tumors. All the data regarding developed complications was recorded via study proforma. Data was analyzed by using the SPSS version 20. 
 Results: Most of the patients were found with age groups of 20 to 34 years and 35 to 55 years. Out of all, 25 patients were diagnosed papillary carcinoma, 12 patients were diagnosed as follicular carcinoma, 7 patients had Anaplastic carcinoma, 4 patients were diagnosed lymphoma and 2 patients were diagnosed as medullary carcinoma. As per complications of advanced disease 23 patients had thyroid swelling with cervical lymphadenopathy and pain, 13 patients had thyroid swelling with change of voice, 7 patients had thyroid swelling with dyspnea and dysphagia, 5 patients were presented with thyroid swelling with bony pain, weight loss and pathological fractures, 2 patients were presented with thyroid swelling with diarrhea.
 Conclusion: Various complications such as swelling, pain, hemorrhage, cervical lymphadenopathy, change in voice, weight loos, pathological fracture, dyspnea and dysphagia were frequently seen in patients presented with advanced stage of thyroid disease.
Highlights
Complications in thyroid tumors are common problem all over the world
As per complications of advanced disease 23 patients had thyroid swelling with cervical lymphadenopathy and pain, 13 patients had thyroid swelling with change of voice, 7 patients had thyroid swelling with dyspnea and dysphagia, 5 patients were presented with thyroid swelling with bony pain, weight loss and pathological fractures, 2 patients were presented with thyroid swelling with diarrhea
Various complications such as swelling, pain, hemorrhage, cervical lymphadenopathy, change in voice, weight loos, pathological fracture, dyspnea and dysphagia were frequently seen in patients presented with advanced stage of thyroid disease
Summary
Complication of the patient is the thyroid swelling in front of neck. Thyroid tumors is commonly seen in those patients having simple solitary thyroid nodule (goiter) or multinodular goiter [3,4]. Majority of patients present with various complications, with long standing thyroid swelling with rapidly enlarge along with cervical lymph adenopathy, pain in thyroid tumors, change in voice, dyspnea, dysphagia, loss of appetite, weight loss, bone pain, pathological fracture, Diarrhea [1,2,10,11,12,13]. The risk of malignancy in thyroid nodules increases as the serum TSH increases. TSH measurement should be part of the initial workup in every patient with a thyroid nodule and be used as a guide for further management.
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