Incidental Thyroid Carcinoma in Thyroidectomy Specimens and Associated Risk Factors

ABSTRACT Thyroid cancer has shown an upward trend in most parts of the world during the last few decades. In Sri Lanka thyroid malignancy is the second most common cancer in females. Incidental thyroid cancer is an unexpected malignancy seen following thyroidectomy surgery. Aim of the study was to determine the frequency of incidental thyroid carcinoma in thyroidectomy specimens submitted for presumed benign pathological disease entities such as multinodular goiter, toxic nodular goiter, chronic thyroiditis and Grave’s disease and identify the associated risk factors for the development of malignancy. A retrospective study which included 92 cases of thyroidectomy specimens from 3 specialized surgical centers. The cases with a prior fine needle aspiration cytology (FNAC) diagnosis of malignancy or suspicious of malignancy were excluded from the current study. The frequency of incidental thyroid carcinoma was 9. 78 % (09 out of 92 cases). All the cases were confirmed histologically as papillary carcinoma (p < 0.05) and the majority were < 10 mm in diameter (microcarcinoma). Incidental thyroid carcinoma showed a statistically significant association with chronic thyroiditis (p < 0.05). With limited facilities for radiological evaluation and identification of suspicious nodules in the growing numbers of patients with multinodular goiters, the risk of missing incidental thyroid carcinoma especially microcarcinomas, will continue to lurch in the same manner. Keywords: Incidental thyroid carcinoma, thyroidectomy, multinodular goiter