Thyroid Malignancy in Multi Nodular Goitre

Introduction: Multi nodular goitre (MNG) is one of the common presentations of various thyroid diseases. Careful examination discloses their presence in at least 4 % of the general population. Nodules less than 1 cm in diameter are not clinically detectable unless located on the surface of the gland, are much more frequent. Although MNG was traditionally thought to be at low risk for malignancy as compared to its single nodule counterpart, various studies have reported a significant risk. The objective of this study was to determine the incidence and the type of thyroid carcinoma (TC) in multi nodular goitre by doing the histopathological examination of thyroid specimens. Materials and Methods. This prospective observation study was carried out in the department of Surgery at Government Sivagangai Medical College, Tamilnadu, India during the period November 2013 to October 2019. All patients with multi-nodular goiter with or without thyrotoxicosis were evaluated and they were offered surgery as the treatment for suspicious findings, cosmesis, compressive symptoms and thyrotoxicosis. The specimens were subjected to a histopathological evaluation to determine the incidence and the types of various malignancies in MNG. Results. Among the 65 MNG cases which were studied, 8 (12.5 %) cases contained malignant foci. Among them, papillary carcinoma was seen in 7 cases (87.5 %), which is the most common type of malignancy was observed. Conclusion. The incidence of malignancy in MNG is quite significant and it is not very low as was thought before. Due to the risk of occult malignancy, all the patients with multi – nodular goitres who are treated conservatively need a close follow up for malignancy.