multinodular goitre
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2021 ◽  
Vol 9 (1) ◽  
pp. 86
Author(s):  
Sreenidhi G. M. ◽  
Jyothi S.

Background: Over the past few decades, the incidence of thyroid cancer has dramatically increased. Thyroid malignancy in multinodular goitre is considered to be high and these occult malignancies are detected only in post operative histopathological analysis. The study helps in finding association between multinodular goitre and thyroid malignancy. Objective was to find the association between multinodular goitre and thyroid malignancy in those who underwent total thyroidectomy.Methods: A cross sectional study conducted in department of general surgery, KIMS hospital, Bangalore. The 236 randomized cases of multinodular goitre who underwent total thyroidectomy were selected. Patients underwent thorough clinical examination pre operatively and were reassessed in post-operative period following surgery. Later, histopathology report on thyroidectomy specimen of the patients were obtained. This report was considered the gold standard for the diagnosis of thyroid malignancy.Results: Occult malignancies were commoner in middle aged females. Most of the patients in the study underwent total thyroidectomy. The prevalence of thyroid malignancy in our study was found to be 7.2%.  In the study, 17 incidental malignancies were papillary carcinomas. It revealed a highly significant relation between the lymphocytic thyroiditis and occult malignancy (p<0.0001)Conclusions: The prevalence of malignancy in multinodular goitre is 7.2%. The only variant of incidental malignancy detected in histopathological examination of excised thyroid was papillary carcinoma. There is a statistically significant association between presence of thyroiditis in preoperative FNA and presence of occult malignancy carcinoma.


2021 ◽  
Vol 14 (12) ◽  
pp. e246432
Author(s):  
Timothy James Goblirsch ◽  
Ambika E Paulson ◽  
Gerti Tashko ◽  
Asefa Jejaw Mekonnen

The SARS-CoV-2 vaccines have had an overwhelming success in curbing the COVID-19 global pandemic, accounting for countless lives saved. Adverse reactions are inevitable, given the vast scale of vaccination required to mitigate future surges of COVID-19. Hyperthyroid disorders have been reported as potential adverse reactions to SARS-CoV-2 vaccines in two patients with Graves’ disease and a group of adults with subacute thyroiditis occurring in young women healthcare workers. We report a case of clinical Graves’ disease in a woman with a previously stable multinodular goitre that occurred 14 days following her second dose of Pfizer-BioNTech SARS-CoV-2 vaccine.


Author(s):  
Hafiz Naweed Ahmad ◽  
Fayyaz Ahmad ◽  
Admin

Objective: To study multinodular goitre patients’ surgery by direct observation of surgical technique, and to compare complications with surgeons’ skills and experience, for improved training of future thyroid surgeons. Methods: Based on positivist epistemology and analytical observational design, this prospective double-blind study of a cohort of multinodular goitre patients operated upon by variedly experienced surgeons, was conducted at Bahawal Victoria Hospital Bahawalpur and Nishtar Medical University Hospital Multan, Pakistan, from December 2016 to April 2019. Patients were admitted through outpatient department and operated upon in routine operation lists. The surgeons were specialists/senior registrars, assistant professors, associate professors and professors. The patients were divided into two virtual groups: the one operated upon by surgeons with >3 years of post-fellowship experience and the other operated upon by surgeons with <3 years of post-fellowship experience. Surgeries were directly observed and differences in surgical technique and complications were recorded for respective groups. Data was analysed using SPSS 20. Results: Of the 134 patients, there were 73(54.5%) in group 1 and 61(45.5%) in group 2. Overall, there were 119(88.8%) females and 15(11.2%) males. The overall mean age was 37.17+/-13.41 years (range: 14-80 years). Of the 25 surgeons, 13(52%) were in group 1 and 12(48%) in group 2. Group 1 had fewer complications compared to group 2, which on certain parameters was statistically significant (p<0.05). Conclusion: Surgeons’ experience and technique were found to have significant relationship with the rate of complications. Direct observation of surgeries is significant for real life evaluation and training of junior surgeons.


2021 ◽  
Vol 29 (2) ◽  
pp. 164-168
Author(s):  
Koustav Mondal ◽  
Chiranjib Das

Introduction Multinodular goitre (MNG) is defined as multiple palpable distinct nodules in the enlarged thyroid gland. MNG can harbour malignancy in 1-10% cases. We undertook the present study to correlate the clinical, radiological and cytological features of MNG with that of final histopathological diagnosis. Materials and Methods A prospective cohort study was done in a tertiary care hospital in northern part of West Bengal from January 2018 to December 2019. Patients aged between 12 years and 75 years, presenting with MNG on clinical examination, were included in the study. We compared the pre-operative ultrasonography (USG) of neck and fine needle aspiration cytology (FNAC) reports with post-operative histopathological examination (HPE) report. Results Among 100 patients 80 were female and 20 were male. Most patients were in 41-50 years age group. For detection of malignancy in MNG, USG had 40% sensitivity, 97.78% specificity, 66.67% positive predictive value (PPV), 93.62% negative predictive value (NPV), and 92% diagnostic accuracy. Sensitivity, specificity, PPV, NPV and diagnostic accuracy of FNAC for detection of malignancy in MNG were 20%, 93.33%, 25%, 91.3% and 86% respectively. When USG features were combined with FNAC features non-diagnostic result decreased from 6% to 2% and diagnostic accuracy for detecting malignancy in MNG increased from 86% to 90%. Conclusion USG and FNAC are complementary to each other in the diagnostic workup of MNG. USG guided FNAC is still better for reaching final diagnosis and exclusion of malignancy.


2021 ◽  
Vol 12 ◽  
Author(s):  
Mays Altaraihi ◽  
Thomas van Overeem Hansen ◽  
Eric Santoni-Rugiu ◽  
Maria Rossing ◽  
Åse Krogh Rasmussen ◽  
...  

IntroductionDICER1 syndrome encompasses a variety of benign and malignant manifestations including multinodular goitre, which is the most common manifestation among individuals carrying pathogenic DICER1 variants. This is the first study estimating the prevalence of pathogenic DICER1 variants in young individuals with multinodular goitre.MethodsDanish individuals diagnosed with nodular goitre based on thyroidectomy samples in 2001-2016 with the age limit at time of operation being ≤ 25 years were offered germline DICER1 gene testing.ResultsSix of 46 individuals, 13% (CI [3.3;22.7], p &lt;0.05), diagnosed with nodular goitre on the basis of thyroidectomy samples under the age of 25 years had pathogenic germline variants in DICER1. They were found in different pathoanatomical nodular goitre cohorts i.e. nodular goitre (n=2), colloid nodular goitre (n=3) and hyperplastic nodular goitre (n=1).ConclusionsWe recommend referral of patients thyroidectomised due to goitre aged &lt;21 years and patients thyroidectomised due to goitre aged &lt;25 years with a family history of goitre to genetic counselling. Patients of all ages thyroidectomised due to goitre, who are affected by another DICER1 manifestation should be referred to genetic counselling.


Author(s):  
SS Elbalka ◽  
IH Metwally ◽  
M Shetiwy ◽  
S Awny ◽  
O Hamdy ◽  
...  

Introduction Thyroid cancer is increasing in incidence globally due either to early detection (overestimation) or true increment. A recent debate concerns multinodular goitre (MNG) or toxic goitres which have classically been considered at a lower risk for cancer. Methods In this study, we enrolled retrospectively all patients with nodular goitre treated at our tertiary hospital and analysed their data with the aim of detecting the rate of cancer among different types of nodular goitre. We also studied predictors of incidental malignancy among thyroidectomies. Results A predilection for solitary thyroid nodules (STNs) was found in women of younger age, with STNs tending to be larger in comparison with MNG in the same age group. However, both types of nodules were at equal risk of harbouring malignancy. Thyroid Imaging Reporting and Data System (TI-RADS) and Bethesda scores were the only dependent predictors of malignancy within thyroid nodules. Conclusion The authors recommend management of both STNs and MNG using the same algorithm.


2021 ◽  
Author(s):  
Kanyada Koysombat ◽  
Zahra Rehman ◽  
Htet Htet Aung ◽  
Sarra Elmustafa ◽  
Nyan Lin ◽  
...  
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Author(s):  
Duygu Temiz Karadag ◽  
Berrin Cetinarslan ◽  
Murat Kasap ◽  
Nuh Zafer Canturk ◽  
Gurler Akpinar ◽  
...  

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