Trends in Thyroid Nodules and Malignancy: A Two-Year Retrospective Study in a Tertiary Care Centre.

Abstract

Thyroid nodules are one of the most common presentations faced by ENT clinicians, and the prevalence of differentiated thyroid cancer is increasing worldwide. We found no other study showing a clear occurence of cancer in thyroid nodules in the state of West Bengal. Hence, we undertook this study to determine the occurence of thyroid cancer among people with thyroid nodules. A retrospective review was performed for 96 patients with thyroid nodules who underwent USG and Fine Needle Aspiration Cytology (FNAC) and thyroid surgery at a tertiary hospital in Kolkata over a 2-year period from January 2020 to December 2021. The occurence of thyroid cancer in patients with thyroid nodules; association with age, sex, duration of thyroid swelling and thyroid stimulating hormone (TSH) levels of the patients; the sonographic findings (nodule size and number) and Bethesda classification on FNAC were reviewed. A total of 96 cases were reviewed. The highest malignancies were seen in swellings of 3-5years duration (50%), and in patients with increased TSH levels (60%). Patients with single vs. multinodular goitre had comparable rates (23.07 vs 22.22%). The highest risk was seen in nodules 1-2cm in size. A TIRADS score of 2 had a negative predictive value of 86.95% and a score of 5 had a positive predictive value of 100%. BETHESDA II lesions had a 3.44% rate of malignancy, while BETHESDA V and VI had rates of 100% and 75% respectively. While most of the thyroid swellings were benign, 22.91% were malignant, the most common being papillary carcinomas.