Thyroid Carcinoma in Multinodular Goiter Systemic Review in Al-Imamin Al-Kadhimian Teaching Hospital

Background: Multinodular goiter (MNG) is a frequent thyroid disease which involves multiple thyroid nodules. Although MNG is usually benign, there is a high chance of malignancy, so its assessment and management is essential.

Aim: To determine the incidence of thyroid cancer in patients with MNG who undergo thyroidectomy at Al-Imamin Al-Kadhimian Teaching Hospital.

Methods: This observational study reviewed 100 cases of MNG that had thyroidectomy. Malignancy was diagnosed by histopathological tests. Demographic variables such as age, sex, body mass index (BMI), duration of goiter, nodule size, place of residence, family history, lymphadenopathy (LAP), dysphagia, shortness of breath (SOB), diabetes mellitus (DM) and hypertension (HT) were also evaluated.

Results: In a study of 100 cases, 19% were found to be malignant. Thyroid malignancies were of papillary (47.4%), follicular (36.8%), medullary (5.3%) and anaplastic (10.5%) types. The incidence of malignancy increased with age, with none in the age group below 40 years, 47.4% in 40-59 years and 52.6% in 60 years and older. Women were more likely to have a malignancy (57.9%). BMI was not found to be a risk factor. The mean duration and nodule size of malignant goiters were greater (5.21 years and 27.53 mm, respectively) than benign goiters. Rural patients (47.4%), those with family history (31.6%), LAP (26.3%), dysphagia (15.8%) and SOB (52.6%) had a higher risk of malignancy.

Conclusion: The findings of the study show a high risk of malignancy in MNG in elderly patients, women, and those with larger size and long duration of nodules. Risk factors include rural area, positive family history, LAP, dysphagia, and SOB. The results highlight the importance of careful work-up and management of MNG to facilitate early diagnosis and treatment of thyroid cancers.