Thyroid cancers in nodular goitres in Northwestern Nigeria

Background : Cancer is an occasional incidental finding in nodular goitres, but there has been no formal study on this disease in our centre which is located in an endemic goitrous region. Aims and objectives: To determine the prevalence and pattern of malignant growths in multinodular goitres. Methodology : This is a seven year (2000-2006) retrospective study of all histologically diagnosed malignancies within nodular goitres at Aminu Kano Teaching Hospital, Kano Results : There were 160 multinodular goitres during the study period, out of which 24 (15.0%) had histologically diagnosed cancer and one out of the thirteen patients with solitary thyroid nodule (7.6%) had carcinoma. The ages of the patients with carcinoma ranged from 16 to 65 years, with a mean age of 38.8 years. Eighteen (72%) were females, and 7(28%) were males. Six out of the 25 cases of carcinoma were detected preoperatively by fine needle aspiration cytology. Well differentiated follicular carcinoma was the predominant histological type in 13 (52%) cases, followed by papillary in ten (40%), medullary carcinoma in one (4%) and anaplastic carcinoma in one (4%) patient. Conclusion : One-seventh of nodular goitres in our centre harboured malignancy, and follicular carcinoma was the prevalent histological type. This is consistent with the findings elsewhere in endemic goitrous regions. Ultrasound guided fine needle aspiration would improve preoperative diagnosis and guide appropriate surgical management