MALIGNANCY INCIDENCE IN SOLITARY NODULE THYROID

Authors

  • JOSE V STANLEY Deparment of General Surgery, Government Medical College, Kottayam, Kerala, India
  • MURALI TV Department of Surgical Oncology, Government Medical College, Kottayam, Kerala, India.
  • SAM CHRISTIE MAMMEN Deparment of General Surgery, Government Medical College, Kottayam, Kerala, India
  • MATHEW PHILIP PALLIKAMATTOM Department of Surgical Oncology, Government Medical College, Kottayam, Kerala, India.
  • SHEEJA S Department of Pathology, Government Medical College, Kottayam, Kerala, India.

DOI:

https://doi.org/10.22159/ajpcr.2025v18i5.54366

Keywords:

Adenomatous nodule, Papillary carcinoma thyroid, follicular carcinoma thyroid, Solitary nodule thyroid, thyroiditis

Abstract

Objectives: The incidence of thyroid cancer is rising in the state of Kerala. This study aimed to determine the incidence of malignancy in solitary nodule thyroid (SNT) cases operated on at our tertiary care hospital.

Methods: This is a retrospective register based study. All patients operated for SNT over 8 years from 2013 to 2020 were listed and pathological findings were evaluated.

Results: A total of 319 patients with SNT were included, with 75.5% being female. The mean age of patients was 42 years (standard deviation=±12.6). Histopathological analysis revealed malignancy in 16% (n=51) of cases. Other most common pathology observed in SNT cases was nodular colloid goiter (67.8%), followed by thyroid adenoma (13.2%), adenomatous nodule (1.9%), and thyroiditis. Among the 51 malignant cases, 70.5% were papillary carcinoma, 25.5% were follicular carcinoma, and one case each of medullary and poorly differentiated carcinoma was identified. A statistically significant association was found between age and malignancy diagnosis (p=0.011, Independent samples t-test). In addition, females had a higher incidence of cancer, with a p=0.021 and an odds ratio of 2.7 (Chi-square test).

Conclusion: A solitary nodule has a 16% chance of malignancy, with papillary thyroid carcinoma being the most common type.

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References

Usha Menon VU, Sundaram KR, Unnikrishnan AG, Jayakumar RV, Nair V, Kumar H. High prevalence of undetected thyroid disorders in an iodine sufficient adult South Indian population. J Indian Med Assoc. 2009 Feb;107(2):72-7, PMID: 19585813

Haridas TV, Bindhu V, Vinodh M. Clinicopathological characteristics of solitary nodule of thyroid- a cross-sectional study in a tertiary center. J Evid Based Med Healthc. 2017 Jan;4(28):1630-2. doi: 10.18410/ jebmh/2017/318

Monib S, Farkas N, Abdelaziz MI. A prospective observational study assessing the relationship between solitary thyroid nodule size and incidence of malignancy. Cureus. 2020 Nov;12(11):e11422. doi: 10.7759/cureus.11422, PMID: 33312818

Sekkath Veedu J, Wang K, Lei F, Chen Q, Huang B, Mathew A. Trends in thyroid cancer incidence in India. J Clin Oncol. 2018 May;36(15-Suppl):e18095. doi: 10.1200/JCO.2018.36.15-suppl.e18095

HBCR Report; 2017. Available from: https://www.rcctvm.gov.in/ pdf/annualreports/hbcr%20report%202017.pdf [Last accessed on 2023 Jun 28].

Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 2015 American thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American thyroid association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid. 2016 Jan;26(1):1-133. doi: 10.1089/thy.2015.0020, PMID: 26462967

Geothe J, Poulose KP. Histologic pattern of thyroid disorders in Southern Kerala. Thyroid Res Pract. 2017 Jan;14(1):25-7. doi: 10.4103/0973- 0354.200566

Pemayun TG. Current diagnosis and management of thyroid nodules. Acta Med Indones. 2016 Jul;48(3):247-57. PMID: 27840362

Rehman AU, Ehsan M, Javed H, Ameer MZ, Mohsin A, Aemaz Ur Rehman M, et al. Solitary and multiple thyroid nodules as predictors of malignancy: A systematic review and meta-analysis. Thyroid Res. 2022 Dec;15(1):22. doi: 10.1186/s13044-022-00140-6, PMID: 36464691

Brito JP, Yarur AJ, Prokop LJ, McIver B, Murad MH, Montori VM. Prevalence of thyroid cancer in multinodular goiter versus single nodule: A systematic review and meta-analysis. Thyroid. 2013 Apr;23(4):449-55. doi: 10.1089/thy.2012.0156, PMID: 23067375

Wong KT, Ahuja AT. Ultrasound of thyroid cancer. Cancer Imaging. 2005 Dec;5(1):157-66. doi: 10.1102/1470-7330.2005.0110, PMID: 16361145

Kwak JY, Han KH, Yoon JH, Moon HJ, Son EJ, Park SH, et al. Thyroid imaging reporting and data system for US features of nodules: A step in establishing better stratification of cancer risk. Radiology. 2011 Sep;260(3):892-9. doi: 10.1148/radiol.11110206, PMID: 2177195913. Zhang F, Russell YX, Guber HA. Transverse and longitudinal ultrasound location of thyroid nodules and risk of thyroid cancer. Endocr Pract. 2021 Jul;27(7):682-90. doi: 10.1016/j.eprac.2021.01.009, PMID: 33642256

Ramundo V, Lamartina L, Falcone R, Ciotti L, Lomonaco C, Biffoni M, et al. Is thyroid nodule location associated with malignancy risk? Ultrasonography. 2019 Jul;38(3):231-5. doi: 10.14366/usg.18050, PMID: 30690963

Khan SA, Gafur MA, Khan MK, Karim MR, Mohiuddin M, Islam MS. Pattern of malignancy in clinically solitary thyroid nodule. Mymensingh Med J. 2012 Jan;21(1):1-7. PMID: 22314446

Hoang J. Thyroid nodules and evaluation of thyroid cancer risk. Australas J Ultrasound Med. 2010 Nov;13(4):33-6. doi: 10.1002/ j.2205-0140.2010.tb00177.x, PMID: 28191095

Yan HX, Pang P, Wang FL, Tian W, Luo YK, Huang W, et al. Dynamic profile of differentiated thyroid cancer in male and female patients with thyroidectomy during 2000-2013 in China: A retrospective study. Sci Rep. 2017 Nov;7(1):15832. doi: 10.1038/s41598-017-14963-z, PMID: 29158505

Amir A, Sands N, Hier M, Payne R. Gender as a risk factor of malignancy in a thyroid nodule. Otolaryngol Head Neck Surg. 2010 Aug;143(S2):P61. doi: 10.1016/j.otohns.2010.06.068

Rahbari R, Zhang L, Kebebew E. Thyroid cancer gender disparity. Future Oncol. 2010 Nov;6(11):1771-9. doi: 10.2217/fon.10.127, PMID: 21142662

McDermott MT. Hypothyroidism. Ann Intern Med. 2020 Jul;173(1):ITC1-16. doi: 10.7326/AITC202007070, PMID: 32628881

Hu X, Chen Y, Shen Y, Tian R, Sheng Y, Que H. Global prevalence and epidemiological trends of Hashimoto’s thyroiditis in adults: A systematic review and meta-analysis. Front Public Health. 2022;10:1020709. doi: 10.3389/fpubh.2022.1020709, PMID: 36311599

Caleo A, Vigliar E, Vitale M, Di Crescenzo V, Cinelli M, Carlomagno C, et al. Cytological diagnosis of thyroid nodules in Hashimoto thyroiditis in elderly patients. BMC Surg. 2013;13(Suppl 2):S41. doi: 10.1186/1471- 2482-13-S2-S41, PMID: 24266923

Yildirim D, Gurses B, Gurpinar B, Ekci B, Colakoglu B, Kaur A. Nodule or pseudonodule? Differentiation in Hashimoto’s thyroiditis with sonoelastography. J Int Med Res. 2011;39(6):2360-9. doi: 10.1177/147323001103900636, PMID: 22289555

Tam S, Amit M, Boonsripitayanon M, Busaidy NL, Cabanillas ME, Waguespack SG, et al. Effect of tumor size and minimal extrathyroidal extension in patients with differentiated thyroid cancer. Thyroid. 2018 Aug;28(8):982-90. doi: 10.1089/thy.2017.0513, PMID: 29936892

Mitchell AL, Gandhi A, Scott-Coombes D, Perros P. Management of thyroid cancer: United Kingdom national multidisciplinary guidelines. J Laryngol Otol. 2016 May;130(S2):S150-60. doi: 10.1017/ S0022215116000578, PMID: 27841128

Dideban S, Abdollahi A, Meysamie A, Sedghi S, Shahriari M. Thyroid papillary microcarcinoma: Etiology, clinical manifestations, diagnosis, follow-up, histopathology and prognosis. Iran J Pathol. 2016 Winter;11(1):1-19. PMID: 26870138

Gao R, Jia X, Liang Y, Fan K, Wang X, Wang Y, et al. Papillary thyroid micro carcinoma: The incidence of high-risk features and its prognostic implications. Front Endocrinol (Lausanne). 2019 Feb;10:74. doi: 10.3389/fendo.2019.00074, PMID: 30828316

Suster S. Controversies regarding the interpretation of follicular thyroid nodules. Arch Pathol Lab Med. 2019 Dec;143(12):1472-6. doi: 10.5858/arpa.2019-0301-RA, PMID: 31556698

Namba H, Matsuo K, Fagin JA. Clonal composition of benign and malignant human thyroid tumors. J Clin Invest. 1990 Jul;86(1):120-5. doi: 10.1172/JCI114673, PMID: 1973172

Hicks DG, LiVolsi VA, Neidich JA, Puck JM, Kant JA. Clonal analysis of solitary follicular nodules in the thyroid. Am J Pathol. 1990 Sep;137(3):553-62. PMID: 1975986

Published

07-05-2025

How to Cite

JOSE V STANLEY, et al. “MALIGNANCY INCIDENCE IN SOLITARY NODULE THYROID”. Asian Journal of Pharmaceutical and Clinical Research, vol. 18, no. 5, May 2025, pp. 198-01, doi:10.22159/ajpcr.2025v18i5.54366.

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Original Article(s)