Published: 2017-01-02

Prevalence of malignancy in multinodular goiter and solitary thyroid nodule: a histopathological audit

Seetu Palo, Debadutta Mishra


Background:Thyroid malignancy has varied prevalence worldwide and it is traditionally believed that solitary thyroid nodules are more likely to be neoplastic than multiple nodules.

Methods: Histopathological analysis was conducted on 165 surgically resected thyroidectomy specimens of multinodular goiter (MNG) and 123 cases of solitary thyroid nodule (STN) in order to determine and compare the prevalence and the types of various thyroid malignancies.

Results: 28 of 165 MNG (17%) and 47 of 123 STN (38.2%) were associated with malignancy and the difference was statistically significant. Papillary thyroid carcinoma was the commonest malignancy observed in both the study groups.

Conclusions:We conclude that the prevalence of cancer was significantly higher in STN than MNG. But, since the prevalence of malignancy in MNG was also quite high, every effort should be made to pre-operatively identify any malignant focus in patients presenting with MNG.


Thyroid malignancy, Multinodular goiter, Solitary thyroid nodule, Papillary carcinoma

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DeLellis RA, Williams ED. Tumours of thyroid and parathyroid. In: DeLellis RA, Lloyd RV, Heitz PU, Eng C edts. Pathology And Genetics. Tumors of endocrine organs. World Health Organization Classification of Tumors. Lyon, France: IARC Press; 2004:49-56.

UI Haq RN, Khan BA, Chaudhry IA. Prevalence of malignancy in goitre: a review of 718 thyroidectomies. J Ayub Med Coll Abbottabad 2009;21(4):134-6.

Memon W, Khanzada TW, Samad A, Kumar B. Incidence of thyroid carcinoma in multi-nodular goitres. Rawal Med J. 2010;35(1):65-7.

Gandolfi PP, Frisina A, Raffa M, Renda F, Rocchetti O, Ruggeri C, et al. The incidence of thyroid carcinoma in multi-nodular goitre: a retrospective analysis. Acta Bio Medica Ateneo Parmense. 2004;75:114-7.

Pedamallu R, Pedamallu SB, Rama Rao K, Pedamallu CS. Incidence of occult carcinoma in multi-nodular goitre which was diagnosed on the basis of the histopathological findings. Internet J Surg. 2008;17:1.

Cole WH. Incidence of carcinoma of the thyroid in nodular goitre. Semin Surg Oncol. 1991;7(2):61-3.

Sachmechi I, Miller E, Varatharajah R. Thyroid carcinoma in the single cold nodules and in the cold nodules of multi-nodular goitres. Endocr Pract. 2000;6(1):110-2.

Whelan SL, Parkin DM, Masuyer E. The patterns of cancer in five continents. IARC Sci Publ. 1990;102:152-3.

Cerci C, Cerci SS, Eroglu E, Dede M, Kapucuoglu N, Yildiz M, et al. Thyroid cancer in toxic and non-toxic multi-nodular goitre. J Postgrad Med. 2007;53:157-60.

Rago T, Vitti P. Role of thyroid ultrasound in the diagnostic evaluation of thyroid nodules. Best Pract Res Clin Endocrinol Metab. 2008;22(6):913-28.

Lokhande R ,Gedam BS, Shah Y, Kale V, Tandon M, Ansari I. The accuracy of ultrasonography and fine needle aspiration cytology in the diagnosis of nodular goitre: A prospective analysis of fourty two cases. IJBAR. 2015;6(1):43-6.

Pang HN, Cheng CM. Incidence of cancer in nodular goitres. Ann Acad Med Singapore. 2007;36: 241-3.

Nanjappa BAN, Mohanty A, Aroul TT, Smile SR, Kotasthane D. Thyroid Carcinoma (Tc) in Nodular Goitre. Thyroid Disorders Ther. 2012;1:115. doi:10.4172/2167-7948.1000115.

Tai JD, Yang JL, Wu SC, Wang BW, Chang CJ. Risk factors for malignancy in patients with solitary thyroid nodules and their impact on the management. J Can Res Ther. 2012;8:379-83.

Anwar K, Din G, Zada B, Shahabi I. The frequency of malignancy in nodular Goiter: a single center study. JPMI. 2012;26(1):96-101.

Satihal SN, Palled ER. A study of various clinical presentation of solitary thyroid nodule at tertiary care center. IJRTSAT. 2014;10(2):30-2.

Abu-Eshy SA, Khan AR, Khan GM, al-Humaidi MA, al-Shehri MY, Malatani TS. Thyroid malignancy in multinodular goitre and solitary nodule. J R Coll Surg Edinb. 1995;40:310-2.

Asmatullah, Wahid FI, Khan Q, Khan MR. Multinodular goiter vs. solitary thyroid nodule: a clinicopathological comparison. KJMS. 2014;7(2):206-11.

Ramchandraiah C, Sadgunachary R, Vijayabhargav. Incidence of malignancy in solitary nodule of thyroid. Indian journal of applied research. 2016;6(2):703-7

Sudarshan Babu KG, Shantharam L. A clinicopathological study of solitary nodule of thyroid. IJSR. 2014;3(4):307-9.

Golder S, Satpathy SN, Pandhy RK, Panigrahi R, Ghata S. A clinicopathological study of solitary thyroid nodule. J Pharm Biomed Sci. 2015;05(03):233-7.

Ullah I, Hafeez M, Ahmad N, Muahammad G, Gandapur S. Incidence of thyroid malignancy in multinodular goiter. J Med Sci. 2014;22(4):164-5.

Hussain N, Anwar M, Nadia N, Ali Z. Pattern of surgically treated thyroid disease in karachi Biomedica. 2005;21:18-20.

Baloch MN, Aslam T, Maher M. Rational for near total thyroidectomy. Pak J Surg. 2007:23:177-9.

Vittal S, Kumar KB, Chandrasekharan M, Suchitra V, Jeevarathinam R. Thyroid surgery: indian experience. Indian J Surg. 1993;55:183-7.

Prades JM, Dumollard JM, Timoshenko A, Chelikh L, Michel F, Estour B, et al. Multi-nodular goitre: surgical management and histopathological findings. Eur Arch Otolaryngol. 2002;259:217-21.

Nadeem K, Akhtar N, Tarar JM. Thyroid malignancy in multi nodular goiter; incidence, a retrospective study in southern punjab. Professional Med J. 2013;20(4):587-90.

Hanumanthappa MB, Gopinathan S, Rithin Suvarna R, Rai G, Shetty G, Shetty A, et al. The incidence of malignancy in multi-nodular goitre: a prospective study at a tertiary academic centre. Journal of Clinical and Diagnostic Research. 2012;6(2):267-270.

Benzarti S, Miled I, Bassoumi T, Ben Mrad B, Akkari K, Bacha O, et al. Thyroid surgery (356 cases): the risks and complications. Rev Laryngol Otol Rhinol. 2002;123(1):33-7.

Bhuiyan MMZU, Machowski A. Nodular thyroid disease and thyroid malignancy: experience at polokwane mankweng hospital complex, limpopo province, South Africa. SAMJ. 2015;105(7):570-2.

Koh KB, Chang KW. Carcinoma in multinodular goitre. Br J Surg. 1992;79:266-7.

Awati SM. A study of clinical evaluation and management of multinodular goiter. Int J Sci Stud. 2014;2(8):41-5.