Thyroid malignancy in endemic nodular goitres: prevalence, pattern and treatment.
OBJECTIVE
The epidemiology of thyroid cancers in goitre endemic zones has not been recently reviewed, and changes being currently reported have been from studies in non-endemic areas. The aims of this study were to present the clinical pattern of thyroid malignancy in a goitre endemic area and identify recent changes, if any.


METHODS
The study was conducted at Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria between January 1983 and December 1993. Records of patients with nodular goitres treated with thyroidectomy were reviewed, and the clinical features, laboratory parameters, treatment, outcome and follow-up of histologically-proven malignant cases were studied.


RESULTS
Thirty-six of 279 (12.9%) patients, aged 13-85 years (mean)=43.7+/-14.7 years), carried malignant goitres, and most (80%) were young or middle-aged women. Of the well-differentiated cancers, follicular type was the most prevalent, being six- and 12-fold as frequent as papillary and medullary cancers (69%vs 11% and 5.6%), respectively. Lymphoma accounted for 5.6%, fibrosarcoma, 5.6% and anaplastic, 2.8%. No relationship was demonstrable between cancer type, duration of goitre and age at diagnosis (r=0.06 and 0.17, respectively).


CONCLUSIONS
Thyroid cancers afflict comparatively young women in our environment, and follicular cancer remains the predominant type, partly as a result of persisting dietary iodine deficiency.
Lawal
O
O
Department of Surgery, College of Health Sciences, Ile-Ife, Osun State, Nigeria. olawal@oauife.edu.ng
Agbakwuru
A
A
Olayinka
O S
OS
Adelusola
K
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006043:Goiter, Endemic / Q000150:complications*; D006044:Goiter, Nodular / Q000150:complications*; D006801:Humans; D007455:Iodine / Q000172:deficiency; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D013964:Thyroid Neoplasms / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D013965:Thyroidectomy; D016896:Treatment Outcome
D007455:Iodine