Abstract
A retrospective analysis of 66 cases of thyroid cancer presenting as a solitary thyroid nodule (STN) from an endemic area is presented herein. The workup included TSH estimation and radionuclide scanning and patients were divided into two groups. Group A included cases of STN carcinoma diagnosed histologically in patients clinically presenting as a benign STN. Of all the patients who presented with a benign STN, malignancy was found more frequently in ‘cold’ nodules (13.5 per cent), than in nodules with a different presentation on scintiscanning (0–9.5 per cent). Cancers occurred in 5 per cent of the females and in 19.5 per cent of the males. Group B included patients with overt signs of malignancy. In both groups, the clinical behaviour was determined by the stage at presentation according to TNM classification. TNM staging was found to be a good prognostic indicator, comparable to histopathology. Thus, locoregional recurrence and mortality were found to be higher in advanced T3 lesions and in Group B patients. On the basis of these findings it is suggested that STN cancers may either be an earlier stage of the disease or that the STN cancers in the two groups may be separate disease entities.
Similar content being viewed by others
References
Correa P. Pathology of endemic goitre. In: Stanbury JB, Hetzel BS eds. Endemic goitre and endemic cretinism. Wiley Eastern Ltd., New Delhi, 1980; pp. 303–332.
Buckwalters JA, Colin GT Jr. Selection of surgical treatment for well differentiated thyroid carcinomas. Ann Surg 1972; 176: 565–578.
Kapur MM, Sarda AK, Bal S, Sood S. Carcinoma of the thyroid: differential behaviour in solitary and multinodular tumors. Br J Surg 1986; 73: 894–895.
Halnan KE. Cancer Treatment. London: Chapman & Hall, 1982.
Hedinger C, Sobin LH. International Histological Classification of Tumors No. 11, Geneva, WHO, 1974.
Kapur MM, Sarda AK, Kumar A. The cold solitary thyroid nodule. Ind J Cancer 1980; 17: 172–175.
Ron E, Modan B. Thyroid. In: Schottenfeld D, Fravmeni JF Jr eds. Cancer epidemiology and prevention. W.B. Saunders Co. Philadelphia 1982; pp. 837–854.
Wahner HW, Cuello C, Correa P, Uribe LF, Gaitan E. Thyroid carcinoma in an endemic goitre area: Cali, Columbia. Am J Med 1966; 40: 58–66.
Mazzaferri EL, Young RL, Oertel JE, Kemmerer WT, Page CP. Papillary thyroid carcinoma: The impact of therapy in 576 patients. Medicine 1977; 56: 171–196.
Kapur MM, Karmarkar MG, Sarda AK, Kumar A, Kochar GS. Thyrotropic hormone (TSH) studies in early and late carcinoma of the thyroid. In: Ui N, Torizuka K, Nagataki S, Miyai K eds Current Problem in Thyroid Research International Congress Series No. 605, Excerpta Medica, Amsterdam-Oxford-Princeton 1982; pp. 581–58.
Dewan SS. Incidence of thyroid cancer in solitary and multinodular goitre. In: Shah DH, Noronha OPD eds. Thyroid Cancer. Role of radionuclides in diagnosis, management and treatment. Radiation Medical Centre, Bhabha Atomic Research Centre, Bombay, 1986; pp. 15–23.
Ramalingaswamy V, Subramaniam TA, Deo MG. The etiology of Himalayan endemic goitre. Lancet 1961; i: 791–794.
Correa P, Cuello C, Eisenberg H. Epidemiology of different types of thyroid cancer. In: Chr E Hedinger ed. Thyroid Cancer UICC Monograph Series Vol. 12. Heinemann: London, 1969; pp. 81–92.
Williams ED, Doniach MD, Bjarnason O, Michie W. Thyroid cancer in an iodine ridh area: A histopathological study. Cancer 1977; 39: 215–222.
Cady B, Sedgwick CE, Meissner WA, Bookwalter JR, Romagosa V. Changing clinical, pathologic, therapeutic and survival patterns in differentiated thyroid carcinoma. Ann Surg 1976; 184: 541–553.
Clark OH, Castner BJ. Thyrotropin ‘receptors’ in normal and neoplastic thyroid tissue. Surgery 1979; 85: 623–632.
Clark OH, Gerend PL, Cote TC, Nissenson RA. Thyrotropin binding and adenylate cyclase stimulation in thyroid neoplasms. Surgery 1981; 90: 252–261.
Caravon P, Thomas-Morvan C, Castanas E, Tubiana M. Human Thyroid cancer: Membrane thyrotropin binding and adenylate cyclase activity. J Clin Endocrinol Metab 1980; 51: 915–920.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Sarda, A.K., Bal, S. & Kapur, M.M. Thyroid carcinoma in an endemic area rresenting as solitary thyroid nodules. The Japanese Journal of Surgery 18, 409–414 (1988). https://doi.org/10.1007/BF02471465
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF02471465