MULTI NODULAR GOITER

FREQUENCY OF MALIGNANCY AND ITS HISTOPATHOLOGICAL TYPES. A TERTIARY CARE HOSPITAL EXPERIENCE

Abstract

Objective: I. To determine the frequency of malignancy in multi nodular goiter. II. To determine the histopathological types.
Design: This is a prospective study. Setting: Surgical department of Foundation Hospital Rawalpindi and associated Teaching Hospital of
Frontier Medical College Abbottabad. Period: Aug. 2002 to Aug. 2007. Patients and Methods. One hundred patients with Multi nodular were
included in this study. Patient with diffuse goiter, solitary nodules, patient operated somewhere else and suspected cases of malignancy were
excluded from the study. Tissue were sent to Armed Force Institute for histopathological examination. Patients were followed for 2 weeks after
surgery with histopathological report, all the preoperative and postoperative findings were recorded in detail. Data was analyzed byusing
SPSS 14. Results. Majority of patients studied, belonged to Azad Kashmir and Gilgit which are among the known endemic regions for goitre
in Pakistan and other from Chakwal and Jhelum. Histopathology revealed 96 (96%) patients with multi nodular goiter, 3 (3%) papillary carcinoma
and 1 (1 %) Follicular carcinoma. Conclusions: Multinodularity of the goitre should not be considered as low risk of malignancy and delay for
surgical intervention. Changes in the size of gland, the appearance of new and hard nodules or cervical lymphadenopathy may indicate
malignant change and prompt indication for surgery.