ABSTRACT

Frequency of the incidental thyroid carcinoma (ITC) is variable in patients operated on for benign nodular thyroid disease (BNTD). The aim of this study is to determine the incidence of incidental carcinoma or microcarcinoma among patients with BNTD, to investigate the malignancy rate in dominant or non dominant nodule and discuss our operation choice in patients having BNTD.

The records of 643 patients operated for BNTD were reviewed retrospectively. Initially the patients data were divided into 5 groups according to the dominant nodule size that was identified and measured by US and finally patients were classified in two groups as benign disease (BD) and ITC according to the final pathology results. Demographic and clinical features were compared in two groups. In the cases with ITC, the tumor’s location in dominant or non dominant nodule and the effect of the nodule diameter on malignancy in tumors originating from dominant nodule were evaluated.

ITC rate was found as 30/643 (4.7%) in our series and false negativity rate of FNAC in dominant nodules was found as 16/643 (2.5%). Number of tumor cases in dominant nodule was similar with the non dominant nodules as 16 and 14, respectively. The most preferred surgical procedure was bilateral subtotal thyroidectomy (BST) which was applied to 283 patients, while total thyroidectomy (TT) and near total thyroidectomy (NTT) were applied 288 patients in total.

According to these results dominant nodule may be misleading in patient management and choice of operation.

Keywords: Benign nodular thyroid disease, incidental thyroid carcinoma, dominant nodule