Analysis of Malignant Thyroid Neoplasms with a Striking Rise of Papillary Microcarcinoma in an Endemic Goiter Region

Mathai, Alka Mary; Preetha, K; Devi, S. Valsala; Vicliph, Sam; Pradeep, R.; Shaick, Aqib

doi:10.1007/s12070-017-1156-8

Cited by 7 publications

(7 citation statements)

References 36 publications

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“…Although we found a significant rise in the incidence of PTCs, we did not find a proportionate rise in PTMCs in the centres. Mathai et al [ 14 ] performed a study to assess the rising trend of papillary microcarcinomas in a single institution in the Thiruvananthapuram district of Kerala on a population very similar to ours, albeit in a private healthcare setting. They found the frequency of microcarcinomas in their studies to be 20.9% which was very similar to the 18.9% seen in our study.…”

Section: Discussionmentioning

confidence: 93%

Proportion of papillary thyroid microcarcinoma in Kerala, India, over a decade: a retrospective cohort study

Benny¹,

Boby²,

Chirukandath³

et al. 2023

ecancer

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Background Overdiagnosis is a phenomenon where an indolent cancer is diagnosed that otherwise would not have caused harm to the patient during their lifetime. The rising incidence of papillary thyroid cancer (PTC) in various regions of the world is attributed to overdiagnosis. In such regions, the rates of papillary thyroid microcarcinoma (PTMC) are also rising. We aimed to study whether a similar pattern of rising PTMC is found in Kerala, a state in India, where there has been a doubling of thyroid cancer incidence over a decade. Methods We conducted a retrospective cohort study in two large government medical colleges, which are tertiary referral facilities in the state of Kerala. We collected data on the PTC diagnosis in Kozhikode and Thrissur Government Medical colleges from 2010 to 2020. We analysed our data by age, gender and tumor size. Results The incidence of PTC at Kozhikode and Thrissur Government Medical colleges nearly doubled from 2010 to 2020. The overall proportion of PTMC in these specimens was 18.9%. The proportion of PTMC only marginally increased from 14.7 to 17.9 during the period. Of the total incidence of microcarcinomas, 64% were reported in individuals less than 45 years of age. Conclusion The rise in the number of PTCs diagnosed in the government-run public healthcare centres in Kerala state in India is unlikely to be due to overdiagnosis since there was no disproportionate rise in rates of PTMCs. The patients that these hospitals cater to may be less likely to show healthcare-seeking behavior or ease of healthcare access which is closely associated with the problem of overdiagnosis.

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Section: Discussionmentioning

confidence: 93%

Proportion of papillary thyroid microcarcinoma in Kerala, India, over a decade: a retrospective cohort study

Benny¹,

Boby²,

Chirukandath³

et al. 2023

ecancer

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“…6 An Indian study conducted in an endemic goiter region also had similar results. 22 Other studies have reported follicular carcinoma to be more frequent than medullary carcinoma. 10,12 The absence of representation of follicular carcinoma might be due to the fact that these tumors clinically present as unifocal nodules 3 while only multinodular thyroids were selected in the current study cohort.…”

Section: Discussionmentioning

confidence: 96%

Frequency of Incidental Carcinoma in Thyroids Operated for Multinodular Goiter

Zahid

Usman²,

Tauseef³

et al. 2021

J Islamabad Med Dental Coll

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Background: Multinodular goiter (MNG) is a common disease in Pakistan. However, malignancy can be found occasionally on histopathological examination of resected goiter specimens. The objective of this study was to determine the frequency of malignant lesions on histopathological examination in thyroid specimens operated for multinodular goiter.Material and Methods: A total of 154 patients undergoing thyroid surgery with preoperative diagnosis of multinodular goiter (MNG) at Al Nafees Medical College and Hospital Islamabad, Pakistan were included in this study. The preoperative diagnosis of MNG was made upon physical examination of thyroid and ultrasound (n=62 cases) and FNAC (n=43 cases) was done in selected cases. Gross examination was done and sections were taken from areas of thyroid with varied appearances including hemorrhagic, solid, firm, white, gray, gelatinous as well as necrotic areas. Qualitative variables, were calculated in terms of percentages and mean and standard deviation were used for quantitative variables.Results: Of the 154 patients with preoperative diagnosis of MNG, there were 139 (90%) female and only 15 (10%) male patients. The age range was 14-60 years with a mean age of 36 ± 10 years The incidence of thyroid carcinoma in patients operated for clinical diagnosis of MNG was 8% (n=12). Papillary thyroid carcinoma was the most frequent type of malignancy (83.3%; n=10). Multifocality (60%; n=6), bilaterality (33.3%; n=4) and left lobe involvement (80%; n=8) of thyroid were more common. Microcarcinoma (measuring 1cm or less) was found in 50% (n=5) of these PTC. Histological type of papillary carcinomas greater than 1 cm were follicular variant (n=3; 30%) and conventional (n=2; 20%) types. The maximum measurement of the tumor was 2 cm. In all cases of PTC, rest of the thyroid showed MNG on histopathology.Conclusions: Incidental finding of thyroid malignancy in clinically diagnosed cases of MNG is not unusual. Papillary carcinoma of thyroid is the most common incidental malignant finding in these cases. Multilocularity in thyroid is not an indicator of benign disease process.

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“…The question of whether the presence of multinodular goiter can be considered a risk factor for thyroid carcinoma still raises discussion. Recent findings have shown that the same histopathologically diagnosed papillary lesion exhibits different protein expression behavior if the patient has a history of multinodular goiter prior to the diagnosis of neoplasia [40][41][42].…”

Section: Plos Onementioning

confidence: 99%

Differential gene expression profile of multinodular goiter

et al. 2022

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Introduction The goiter, a neglected heterogeneous molecular disease, remains a major indication for thyroidectomies in its endemic regions. Objectives This study analyzed differential gene expression in surgical specimens diagnosed with multi nodular and compared the data to that of thyroid tissue without multinodular goiter from patients undergoing thyroidectomy in Manaus-AM, Brazil using RNA-seq technology. Methodology The transcriptome information of the surgical specimen fragments with and without multinodular goiter was accessed by Illumina HiSeq 2000 New Generation Sequencing (NGS) using the RNA-seq NEBNext® Ultra™ RNA Library Prep Kit for Illumina®—#E7530L protocol and differential gene expression analysis. Results Differences were found between the gene expression profiles of the diseased tissues and those of the healthy control tissues; at least 70 genes were differentially expressed. The HOTS gene was expressed only in multinodular goiter tissues (p < 0.05). Conclusion These results demonstrate that the gene expression profile of multinodular goiter is pro-tumoral and that HOTS can play a central role in multinodular goiter development.

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Analysis of Malignant Thyroid Neoplasms with a Striking Rise of Papillary Microcarcinoma in an Endemic Goiter Region

Cited by 7 publications

References 36 publications

Proportion of papillary thyroid microcarcinoma in Kerala, India, over a decade: a retrospective cohort study

Proportion of papillary thyroid microcarcinoma in Kerala, India, over a decade: a retrospective cohort study

Frequency of Incidental Carcinoma in Thyroids Operated for Multinodular Goiter

Differential gene expression profile of multinodular goiter

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