Analytical study of the incidence of papillary carcinoma in thyroiditis cases and assessing the risk

Abstract

The thyroid gland or simply, the thyroid in vertebrate anatomy is one of the largest endocrine glands. The thyroid gland is found in the neck, below (inferior to) the thyroid cartilage (which forms the laryngeal prominence, or "Adam's apple"). The isthmus (the bridge between the two lobes of the thyroid) is located inferior to the cricoid cartilage. 1,2 The thyroid gland controls how quickly the body uses energy, makes proteins, and controls how sensitive the body is to other hormones. It participates in these processes by producing thyroid hormones, the principal ones being triiodothyronine (T3) and thyroxine (T4). These hormones regulate the rate of metabolism and affect the growth and rate of function of many other systems in the body. T3 and T4 are synthesized from both iodine and tyrosine. The thyroid also produces calcitonin, which plays a role in calcium homeostasis. 3 Hormonal output from the thyroid is regulated by thyroid-stimulating hormone (TSH) produced by the anterior pituitary, which itself is ABSTRACT Background: The association between thyroid carcinoma and thyroiditis remains controversial in medical bibliography. Therefore, the present study was designed to investigate the incidence of papillary carcinoma in diagnosed cases of thyroiditis patients who underwent surgery and analyze the risk of carcinoma in thyroiditis patients. Methods: Patients of both sexes, age more than 13 with symptomatic thyroid swelling and diagnosed as any sub types of thyroiditis with FNAC/USG/Antibody titer in Government Medical College, Thrissur, India. 41females and 3 male patients were studied to assess risk of carcinoma in thyroiditis cases, analyzing the age, symptoms, clinical presentations and FNAC results. Results: 17 out of 44 cases showed post-operative biopsy as papillary carcinonoma.15 out of 17 papillary carcinoma cases diagnosed were above 36 years, with 6times increased risk, 95% CI = (1.142, 31.532). 10 out of 17 carcinoma cases have rapid increase in size (p=0.00). 82.4% of carcinoma cases have obstructive symptoms (p=0.00). FB sensation is more frequently seen in postoperative benign thyroiditis. 59% of the papillary carcinoma cases were diagnosed pre operatively as colloid with thyroiditis. Conclusions: Females aged more than 36years and all adult males with a rapid increase in size of the thyroid swelling and/or obstructive symptoms like dyspnoea/dysphagia, who's FNAC suggestive of colloid with features of thyroiditis have a high malignant potential for papillary carcinoma, and total/near total thyroidectomy may be considered as an appropriate operative treatment.