Abstract

Objective: To determine the frequency of incidental carcinoma in a multinodular goiter (MNG) considered as benign preoperatively.
Methodology: This prospective observational study was conducted in Mercy Teaching Hospital, Peshawar Medical College, Peshawar, Pakistan from February 2011 to March 2013. We included in this study those cases, which were preoperatively considered as a benign MNG and excluded those with obvious features of malignancy or proved to be malignant on FNAC.
Results: Among 105 cases, there were 6 cases (5.7%) of incidental carcinoma and all of them were differentiated carcinoma of the thyroid. Out of these 6 cases, 4 (66.6%) were papillary carcinoma and two (33.3%) was follicular carcinoma.
Conclusion: The frequency of incidental thyroid carcinoma is high among the patients of
MNG although it is difficult to correctly diagnosed them preoperatively with available diagnostic
tools like FNAC. Therefore, we suggest that all cases of MNG should be treated by
total or near total thyroidectomy to have a good out-come.

Key words: Multi nodular goiter, MNG, Incidental, Papillary carcinoma, Follicular carcinoma.