A clinicopathological study and management of thyroid carcinoma

A total number of 60 patients with thyroid cancer were evaluated in the study period from June 2010 to May 2012 at Madurai Medical College retrospectively. The occurrence of thyroid cancer was maximum in the 4th decade of life followed by the 5th decade of the life. Female gender outnumbered males with a ratio of 5: 1 in this study, the commonest symptom of thyroid malignancy was a painless swelling in the front of the neck (95% of the patients) and the duration of symptoms varied greatly; with 70% of the patients presenting with a duration of less than 1 year. FNAC was helpful in establishing the diagnosis in 80% of cases. Ultrasonography of the neck was found to be very sensitive tool in thyroid carcinoma to find out the features suspicious of the malignancy and the impalpable nodal metastases. The most common histopathological type was papillary carcinoma thyroid (80%); followed by follicular carcinoma thyroid (18.33%) and one case of the anaplastic carcinoma. The age of presentation, gender incidence and the clinical presentations varied between the histological variants of papillary and follicular carcinoma of thyroid. The diameter of the tumour was found to be an independent parameter and statistically correlates with the morphological parameters of the thyroid carcinoma that include the multifocality, extra thyroidal invasion, lymph node and distant metastases and were statistically correlated. Large number of the patients in this study belonged to the high risk category as per AMES Categorization criteria and also to the Stage I disease by AJCC (2010) TNM classification system. Total thyroidectomy was the common procedure required for the treatment for the thyroid malignancies and the extent of the lymph node dissection depends on the level of lymph node involvement and the prophylactic lymph node dissection in well differentiated thyroid cancers are needed in high risk patients. The common complications commonly found in the study were vocal cord palsy and the transient hypoparathyroidism