Prevalence Of Thyroid Malignancy Research Articles

Thyroid Malignancy among Fine Needle Aspiration Cytology of Thyroid Lesions in a Tertiary Care Centre.

The most prevalent endocrine cancer in the world is thyroid cancer, and its incidence is on the rise. The distinction between benign and malignant thyroid nodules must be made, which is why fine needle aspiration cytology of thyroid lesion is necessary and required. This study aimed to find out the prevalence of thyroid malignancy among fine needle aspiration cytology of thyroid lesions in a tertiary care centre. A descriptive cross-sectional study was conducted among fine needle aspiration cytology of thyroid lesions in a tertiary care centre after obtaining ethical approval from the Institutional Review Committee. Data from 13 April 2020 to 13 April 2023 was collected between 19 May 2023 to 19 June 2023. All the patients with complete hospital record data were included in this study. However, repetitive fine needle aspiration cytology of thyroid lesion were excluded from the study. Fine needle aspiration cytology diagnoses were categorized in this study as per the Bethesda system for reporting thyroid cytopathology. The point estimate was calculated at a 95% Confidence Interval. Among 398 fine needle aspiration cytology of thyroid lesions, thyroid malignancy was seen in 12 (3.02%) (1.34-4.70, 95% Confidence Interval) patients. The prevalence of thyroid malignancy was found to be lower than other studies done in similar settings. cytology; malignancy; prevalence; thyroid.

Evaluation of thyroid nodules by ultrasonography with cytological and histopathological correlation

Background: Nodular thyroid is a common clinical entity. The optimum diagnostic strategy for the patient with nodular thyroid is still a matter of debate. A thyroid nodule is a well-defined discrete lesion, sonographically distinct from the surrounding thyroid parenchyma. Thyroid nodules occur with relatively high frequency in the general population with prevalence of 4–7% by palpation alone, 13%–67% by sonographic evaluation, and 50% at autopsy. It is estimated that 4–8% of adult women and 1–2% of adult men have thyroid nodules that can be felt on clinical examination. However, in contrast to high prevalence of thyroid nodules, the prevalence of thyroid malignancy is low. <7% of thyroid nodules are malignant. Aims and Objectives: The present study was undertaken to evaluate the diagnostic efficacy of ultrasonography (USG) and color Doppler in differentiating benign and malignant thyroid nodules and in comparing the findings with results of fine needle aspiration cytology (FNAC). Materials and Methods: A prospective study was carried out on 65 patients from 11–80 years age group of both sexes, presenting with thyroid nodules. All patients were evaluated by gray scale USG and color Doppler and then subjected to FNAC. Histopathology was done whenever required. The results of FNAC were compared with that of USG and color Doppler. Results: The majority of the cases presented were females between the age group of 21–50 years. Swelling in the anterior neck was the presenting complaint in all 65 cases (100%). The most of thyroid nodules were benign in nature. The sensitivity and specificity of US in diagnosing malignant lesions were 80% and 86%, respectively. The most common presentation was from the females in the age group of 21–50 years, with swelling in the anterior neck. Conclusion: USG with color Doppler is a safe, reliable, and cost-effective diagnostic modality with a high sensitivity and specificity and is the single best radiological investigation for non-invasive evaluation of thyroid nodules. However, a combination of FNAC and USG gives optimum results and can avoid unnecessary surgery.

Diagnostic Accuracy of Ultrasonography Using U Classification of Thyroid Nodules in Detection of Malignant Thyroid

Ultrasonography (US) helps diagnose malignant thyroid nodules based on various characteristics, including echogenicity, margins, microcalcifications, size, form, and aberrant neck lymph nodes. The study aimed to determine the diagnostic accuracy of ultrasonography for cancer diagnosis in thyroid nodules, using Histopathology as the gold standard. To minimize morbidity and death from the condition and the number of solely invasive procedures biopsies, the results of our research will give patients and physicians with a noninvasive, cost-effective, and conveniently accessible diagnostic technique for differentiating cancerous from benign nodules. A cross-sectional analytical study was designed to collect data prospectively from July 2022 to October 2022 in the Department of Radiology at Nuclear Medicine, Oncology and Radiotherapy Institute Islamabad. Patients in the age range of 18-60 years, both genders were enrolled. Th data was entered into SPSS 24. The frequencies and percentages of categorical factors such as sex and malignancy in thyroid nodules were determined using descriptive analysis. For numerical variables such as age, the mean and standard deviation were computed. We evaluated the sensitivity, specificity, PPV, and NPV with a 95% confidence interval for the U-classification of malignant thyroid nodules and represented as Two by Two tables. In addition, Histopathology was used to evaluate U's efficacy as a diagnostic tool for finding malignant thyroid nodules. The study sample comprised 34 (68%) female and 16 (32%) male patients. On Biopsy, cancerous nodules were diagnosed in only 19 (38.5%) patients, and the remaining 31 (62%) had benign lesions. The prevalence of thyroid malignancy in our sample was 38%. On ultrasonography, malignancy was diagnosed in 15(30%) lesions, while the remaining 35(70%) patients were diagnosed with benign lesions. Histopathology confirmed malignant thyroid nodules in 15 (true positive) cases, whereas 6 (false positive) had no malignant lesion on Histopathology. In US negative patients, 27 were true negative, while 2 were false negative. The sensitivity of ultrasound U-score in diagnosing malignant thyroid nodules was 88.2%, specificity was 81.8%, PPV was 71.4%, and NPV was 93% Diagnostic accuracy is high when the US is used to detect thyroid problems, making it the preferred noninvasive technique. We recommend that thyroid lesions be routinely assessed clinically, imaged radiographically, and analyzed histo-pathologically. U Classification system for identifying potentially cancerous thyroid nodules is a valuable tool. It allows for a more prudent choice of nodules to undergo FNAC, reducing the number of needless procedures.

Association between multi nodular goitre and thyroid malignancy at a tertiary care centre

Background: Over the past few decades, the incidence of thyroid cancer has dramatically increased. Thyroid malignancy in multinodular goitre is considered to be high and these occult malignancies are detected only in post operative histopathological analysis. The study helps in finding association between multinodular goitre and thyroid malignancy. Objective was to find the association between multinodular goitre and thyroid malignancy in those who underwent total thyroidectomy.Methods: A cross sectional study conducted in department of general surgery, KIMS hospital, Bangalore. The 236 randomized cases of multinodular goitre who underwent total thyroidectomy were selected. Patients underwent thorough clinical examination pre operatively and were reassessed in post-operative period following surgery. Later, histopathology report on thyroidectomy specimen of the patients were obtained. This report was considered the gold standard for the diagnosis of thyroid malignancy.Results: Occult malignancies were commoner in middle aged females. Most of the patients in the study underwent total thyroidectomy. The prevalence of thyroid malignancy in our study was found to be 7.2%. In the study, 17 incidental malignancies were papillary carcinomas. It revealed a highly significant relation between the lymphocytic thyroiditis and occult malignancy (p<0.0001)Conclusions: The prevalence of malignancy in multinodular goitre is 7.2%. The only variant of incidental malignancy detected in histopathological examination of excised thyroid was papillary carcinoma. There is a statistically significant association between presence of thyroiditis in preoperative FNA and presence of occult malignancy carcinoma.

Clinical study of prevalence of malignancy in nodular thyroid swelling

Background: Large proportion of thyroid cancers arose from a pre-existing adenoma or from multinodular goiters. Surgical practice of removing thyroid nodule or multiple nodules of thyroid gland has been challenged for surgeons to prevent cancer. Aim of this study is to find out the prevalence of malignancy in solitary thyroid nodule and multi-nodular goitre in relation to age and sex. The aim of the study was to determine the incidence of malignancy in patients who underwent thyroidectomies.Methods: Study of 100 cases of nodular thyroid swelling has been done during the period from November 2017 to November 2019 on inpatients admitted to GEMS Hospital, Srikakulam, and Andhra Pradesh, India. Detail clinical examination, relevant investigations, surgical management and histopathological reports were collected and analyzed using software package for statistical analysis (SPSS 20).Results: Out of 100 patients with thyroid swellings, thyroid malignancies constitute 4%. The occurrence of thyroid cancer was maximum in the 4th decade of life. Female patients outnumbered males with a ratio of 4:0. Relative frequency of malignancy in solitary thyroid nodule was 4.76% and in multi-nodular goitre was 3.03%. Most common histopathological type was papillary carcinoma thyroid (50%); followed by follicular carcinoma thyroid (25%) and medullary carcinoma (25%).Conclusions: The prevalence of thyroid malignancy in the present study is at an earlier age group due to early diagnosis and treatment. The prevalence of thyroid cancer is higher in female when compared to those reported in the literature. The proportion of medullary cancer is more in present study.

Prevalence of thyroid malignancy and hormonal dysfunction following radiation exposure in childhood

Childhood radiation exposure is a known risk factor for thyroid malignancy and dysfunction. However, local data are limited and there is no consensus on the modality and frequency of screening in this high-risk group. Retrospective analysis study evaluating patients with childhood radiation exposure in 2006-2016 and minimum of 1-year follow-up. Of the 132 childhood cancer survivors in the study, thyroid malignancy was detected in 2 cases (1.5%) and thyroid nodules in 13 (9.8%). The earliest thyroid malignancy was detected 5 years post-radiotherapy via ultrasound. Of the 84 patients who had screening thyroid function test, 26 (31.0%) were detected with abnormal test results post-radiation, majority being subclinical hypothyroidism. Regular screening via clinical examination for thyroid nodules should be performed at least annually. Where feasible and if resources permit, consideration should be given to using ultrasound for thyroid nodule(s) and malignancy screening at 5 years post-radiation therapy. Screening for thyroid dysfunction can be considered from 6-12 months post-radiotherapy.

English

BACKGROUND Thyroid cancer has the most rapidly increasing incidence of all major cancers in India. The overall prevalence of thyroid malignancy is approximately 1 - 5 % of all cancers in women and less than 2 % in men. Thyroid nodules are a common clinical finding and have a reported prevalence of 4 – 7 % in the general population. The vast majority of these nodules are non-neoplastic or benign and the risk of malignancy varies from 5 to 10 %. Fine needle aspiration cytology (FNAC) is an efficient and reliable means for the evaluation of thyroid nodules. A key challenge for clinicians is to choose which thyroid nodule is to be investigated further and treated. Early detection and treatment of malignant thyroid nodules is associated with excellent outcomes. The aim of our study is to compare and correlate between fine needle aspiration cytology and histopathology of resected specimen and to determine the diagnostic accuracy of TBSRTC (The Bethesda System for Reporting Thyroid Cytopathology) in thyroid nodule. METHODS This is a cross sectional validation study conducted in a tertiary care hospital (R.G. Kar Medical College) of Kolkata to find the sensitivity, specificity and diagnostic accuracy of TBSRTC in evaluation of thyroid nodule. RESULTS We have observed that TBSRTC is highly sensitive and specific in stratifying the malignancy risk of thyroid nodule. CONCLUSIONS It aids the clinician to choose the thyroid nodules which require further evaluation and intervention. It also guides the clinician to decide the operability of thyroid nodule. TBSRTC is highly accurate and is highly specific in stratifying the risk of malignancy of thyroid nodule. KEYWORDS TBSRTC, FNAC, Thyroid Nodules, Thyroid Cancer

Long-Term Outcomes of Thyroid Nodule AFIRMA GEC Testing and Literature Review: An Institutional Experience.

To assess outcomes of thyroid nodules analyzed with the AFIRMA gene expression classifier (GEC) and to perform a comprehensive literature review. Retrospective analysis of patients with thyroid nodules who underwent AFIRMA GEC testing at our institution. A tertiary care academic institution. We collected clinical outcomes for 416 thyroid nodules that were analyzed with AFIRMA GEC between 2011 and 2015, including long-term follow-up through 2019. We performed a comprehensive literature review. The resection rate for nodules with "suspicious" GEC results was 85% with a positive predictive value of 37%. The resection rate for nodules with "benign" GEC results was 24% with a negative predictive value of 90%. The prevalence of thyroid malignancy in patients with thyroid nodules with indeterminate cytology at our institution during this timeframe was 41%, thus lowering our negative predictive value. Mean follow-up duration for unresected nodules was 27.8 months. Our resection rates for nodules with "benign" GEC were among the highest reported in the literature. Molecular marker testing of thyroid nodules with indeterminate cytology can aid in the surgical decision making by obviating the need for diagnostic surgery and/or guiding extent of resection. Patients with other indications for surgery may not benefit from such costly testing.

The Prevalence of Thyroid Malignancy in Multinodular Goiter in Erbil Governorate

Background and objectives:thyroid malignancy is relatively a rare tumor, but it represents the most common form of malignancy of endocrine glands. The common scenario in multinodular goiter is finding of incidental thyroid carcinoma after histopathological evaluation of specimens for assumed benign thyroid lesions. The objective of the study was to estimate the prevalence and types of malignancy in multinodular goiter in Erbil governorate, in order to choose the best surgical options for their treatment. Methods:This prospective cross-sectional study has been conducted from 1st March 2017 to 1st March 2018 on 72 patients with multinodular goiter in Rizgary teaching hospital and private hospitals in Erbil city. All patients evaluated preoperatively by history, clinical examination, thyroid function test, ultrasound study, fine needle aspiration cytology. Then, offered operative treatment for compressive symptoms, thyrotoxicosis, cosmetic concerns, undetermined cytology, suspicious or proved malignancy by fine needle aspirationcytology Results: Among 72 cases, 90.3% were females and 9.7% were males, with mean age distribution at the time of surgery was 41.6 ± 12.6 years. 8.3% of patients found to have malignancy on final histological examination and papillar carcinoma constituted 83.3% of cases. Conclusions:-we recommend near-total or total thyroidectomy to eliminate the need for re-operation in case of thyroid cancer.

Thyroid malignancy among patients with thyroid nodules in the United Arab Emirates: a five-year retrospective tertiary Centre analysis

ObjectivesThyroid malignancy constitutes the sixth common cancer type in the United Arab Emirates (UAE). There are no epidemiological data outlining the prevalence of cancer in thyroid nodules, nor previous analysis of ultra-sonographic features correlating with thyroid malignancy in the UAE. This study aimed to estimate the prevalence of thyroid malignancy in patients with thyroid nodules and to describe the ultra-sonographic characteristics of thyroid nodules harbouring malignancy.MethodsA retrospective electronic medical records review of all thyroid nodules in patients (aged 18 to 80 years) with normal thyroid-stimulating hormone (TSH) levels, who underwent ultrasound guided fine needle aspiration cytology (UG-FNA) at Sheikh Khalifa Medical City (SKMC) during 2011–2015.Results436 patients with normal TSH underwent UG-FNA cytological examination of thyroid nodules (n = 555 nodules). The overall crude prevalence of thyroid cancer among patients was 10.1% (95% CI 7.5–13.3). The age-adjusted prevalence of thyroid cancer among UAE nationals, Arabs, Far East Asians, and Caucasians were 9.6% (3.6–15.6), 10.0% (6.2–13.8), 16.8% (4.5–29.0) and 16.3% (1.7–30.9), respectively. The crude prevalence was 14.5%(95% CI 6.2–22.8) in men, and 9.3%(95% CI 6.3–12.2) in women. The echogenicity features were significantly different between the cancerous and noncancerous nodules (p = 0.025). Cancerous nodules were relatively more hyper- and hypo-echoic, while noncancerous nodules were mostly complex.ConclusionWe report a higher prevalence of thyroid malignancy among patients with thyroid nodules relative to that reported in other parts of the world. The rate of thyroid malignancy was higher in patients of Far-East Asian and Caucasian ethnic background.

Abstract #1053 Prevalence of Thyroid Malignancy Among Thyroid Nodules in the United Arab Emirates: Five-Years Tertiary Center Analysis

Abstract #1053 Prevalence of Thyroid Malignancy Among Thyroid Nodules in the United Arab Emirates: Five-Years Tertiary Center Analysis

Thyroid Nodules

Thyroid nodules frequently are encountered incidentally, and although thyroid nodules are common, the prevalence of thyroid malignancy is relatively low. Considerable overlap exists between the appearance of benign and malignant thyroid nodules. Also, the varying guidelines among scientific associations, regarding when biopsy of a thyroid nodule is recommended, create a growing diagnostic dilemma. The initial approach to differentiate benign from malignant thyroid nodules focused on pattern recognition with a recent shift to individual feature analysis by ultrasound. Ultimately, fine-needle aspiration is required for definitive diagnosis; however, it is unrealistic to biopsy every thyroid nodule. The objective of this article is to emphasize the use of both pattern recognition and individual feature analysis to appropriately select candidates for biopsy and follow-up with a goal of identifying clinically significant thyroid cancer and of avoiding unnecessary workup of benign thyroid nodules.

Thyroid cancer: Controversy about over-diagnosis versus the perils of underdiagnosis

Thyroid cancer: Controversy about over-diagnosis versus the perils of underdiagnosis

Prevalence and types of thyroid malignancies among thyroid enlarged patients in Gondar, Northwest Ethiopia: a three years institution based retrospective study.

BackgroundThyroid carcinoma is the leading cause of death among endocrine cancers second to carcinoma of the ovary. Now a day, the incidence of thyroid malignancy is increasing more rapidly than any other malignancy. But data on the prevalence of thyroid malignancy among thyroid enlarged patients were very limited in the study area. Therefore, this study was aimed to determine the prevalence of thyroid malignancies among thyroid enlarged patients.MethodsData of 846 thyroid enlarged patients registered from January 2010 to February 2013 were collected from fine needle aspirate cytology and histology (for inconclusive and the neoplastic cases) log books. It was entered and analyzed using SPSS version 20. Odds ratio was calculated to assess the presence and strength of association between the outcome variable and the explanatory variables. P-values less than 0.05 were considered statistically significant.ResultsAmong the 846 thyroid enlarged patients, 62(7.3%) were confirmed to have malignancy. Among malignancies papillary thyroid carcinoma was the leading, 28 (45.2%), followed by follicular thyroid carcinoma, 18 (29%), and the least type of thyroid malignancies were medullary thyroid carcinoma and hurtle cell carcinoma, each accounts 1 (1.6%). Severe form of thyroid malignancy, undifferentiated thyroid carcinoma, was also accounted significant proportion, 12.9%. Older patients having an age of greater than 60 years and patients with solitary thyroid enlargement were more affected by malignancy compared to the reference age group, 11–20 years and diffused type of enlargement respectively (AOR: 10.96 (3.15-38.1; AOR: 8.82 (3.49-22.32) respectively).ConclusionsThe prevalence of thyroid malignancy was significantly high and the leading type of malignancy was papillary thyroid carcinoma followed by follicular thyroid carcinoma. Thyroid malignancy was found to have statistically significant association with type of enlargement and age.

Diagnostic Value and Cost Considerations of Routine Fine-Needle Aspirations in the Follow-Up of Thyroid Nodules with Benign Readings

Fine-needle aspiration (FNA) is the most accurate tool to identify malignancy in solitary thyroid nodules. Although some recommend routinely repeating FNA for nodules that are initially read as benign, there is no consensus. We evaluated clinical relevancy and considered costs of routine follow-up FNA in nodules initially read as benign. We reviewed the records of all 739 patients who underwent FNA of solitary thyroid nodules at our institution from 1988 to 2004. A total of 815 aspirations were required to obtain satisfactory specimens. According to their physicians practice, some patients had a "follow-up biopsy" after an initially benign FNA reading as a matter of routine (Group I approach) or if their clinical status changed (Group II approach). The outcome information for at least 4 years after the initial FNA in these two groups was compared. In addition, hypothetical costs relating to both methods for deciding whether to do a follow-up FNA were considered. The initial FNA was benign in 576 (78%), suspicious for follicular neoplasms in 106 (14.4%), and malignant in 57 patients (7.7%). Follow-up FNA was performed in 292 patients with initially benign lesions, 235 in Group I approach and 57 in Group II approach. The FNA diagnosis according to Group I approach remained benign on follow-up biopsy in 96.2% (226/235), was altered to follicular neoplasm in 3% (7/235), and was suspicious for malignancy in 0.8% (2/235). When following Group II approach, the follow-up FNA was benign in 93% (53/57), undetermined in 1.7% (1/57), and showed follicular neoplasm in 5.3% (3/57). Combining Groups I and II methods, 5 of 292 patients had a malignant nodule on histological examination, a false-negative rate of 1.7% for the initial FNA, but without a difference in prevalence of thyroid malignancy between the groups. Cost-consequence analysis showed no benefit in routine follow-up FNA after initially benign FNA readings. Routine follow-up FNA in patients whose initial FNA is benign has a low diagnostic upgrading value and is relatively costly. In patients whose initial FNA is benign, we recommend the FNA be repeated only if clinically suspicious signs or complaints develop.

Comparative Study of FNAC and Excisional Biopsy in Thyroid Swelling

To study the FNAC and histopathological pattern of thyroid swelling, prevalence of thyroid malignancy, mode of treatment and associated surgical complications. A total of 100 patients of thyroid swelling were evaluated by FNAC preoperatively and histopathologically after surgery. Reports of FNAC and histopathology were similar in 73% patients while dissimilar in 27%. Among benign tumors diffuse colloid goiter was the most common presentation. Thyroid disease is endemic and colloid goiter is the most common presentation. FNAC is useful in preoperative planning but final diagnosis should be based upon histopathology.

Prevalence of Malignancy in Patients with Tyroid Incidentalomas detected by <sup>18</sup>F-Fluorodeoxyglucose Positron Emission Tomography

Background: Thyroid incidentalomas detected by 18 F-Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) have been reported in 1.1 to 2.9% of scans performed. Previous studies have determined the prevalence of thyroid malignancy in these patients to be 14-72%. Objective: We undertook a retrospective study to determine the prevalence of thyroid incidentalomas in our center, and evaluated the corresponding prevalence for malignancy in these patients. Results: A total of 2,912 FDG-PET scans were performed on 1,855 patients, of which 56 (3.0%) presented with a thyroid incidentaloma (40 focal and 16 diffuse). Among the 22 patients who had an ultrasound, 15 presented with solid nodules (10 focal and 5 diffuse), while 5 were negative for any lesions (4 focal and 1 diffuse). Of 13 patients who had a subsequent FDGPET scan, 8 had resolution of the hypermetabolic foci (61.5%), of which 5 were focal and 3 diffuse. Only 1 of 6 incidentalomas whose histological diagnoses were available showed malignancy (papillary carcinoma). Other cytologic diagnoses include colloid goiter and lymphocytic thyroiditis. Conclusion: The prevalence of thyroid malignancy in focal incidentalomas is 1 in 12 (8.3%) and 1 in 17 in all incidentalomas (5.9%). Our experience indicates that the prevalence rates are much lower than that previously reported. Nevertheless, the prevalence rates are significantly elevated to warrant further evaluation, including an imaging procedure and fine needle aspiration biopsy.