Long Standing Goitre as a risk of thyroid malignancy, review of 160 cases

  • Background: Goitre is endemic in Sudan. Patients present late and most physicians tend to prescribe long term thyroxin therapy . Surgical treatment is resolved to when pressure symptoms are eminent. The reported global risk of malignancy in long standing goitre was 2 – 3%,

    Objective: To report on the risk of malignancy in long standing goitre exceeding 10 years .

    Methods: All patients who underwent total thyroidectomy for goitre exceeding 10 years in Khartoum Teaching Hospital and Fedail Hospital during the period march 2017 to September 2018 were included.

    Results: 160 patients were studied, 28 males (18%) and 132 females (82.0%) ,with male to female ratio of 1.0:4.5. Age ranged between 19 and 81 years with mean age of 52.+13SD. Twenty eight patients (17.5%) had recurrent goitre,. A hundred and thirty one patients were euthyroid (81.9%), 22 hyperthyroid (13.8%) and 7 hypothyroid (4.4%) . Pressure symptoms were present in 151 patients (94.4%0). 76 had retrosternal extension as evidenced by thoracic inlet x-ray in 119 patients (74.4%) and CT scan in 41 patients ( 25.6%). All goitres were delivered via cervical approach and no sternotomy was needed. Forty four patients (27.5 %) had malignant goitre and another 10 non suspicious proved to be malignant (9% incidental malignancy), Histopathology showed 106 were simple nodular goitre (67.5%) and 54 were malignant (32.5%)..

    Conclusion: Long standing goiter has a greater risk of malignant transformation and total thyroidectomy to be recommended for long standing simple goitre.

 

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