Prevalence of malignancy in multinodular goiter and solitary thyroid nodule: a histopathological audit

Background: Thyroid malignancy has varied prevalence worldwide and it is traditionally believed that solitary thyroid nodules are more likely to be neoplastic than multiple nodules. Methods: Histopathological analysis was conducted on 165 surgically resected thyroidectomy specimens of multinodular goiter (MNG) and 123 cases of solitary thyroid nodule (STN) in order to determine and compare the prevalence and the types of various thyroid malignancies. Results: 28 of 165 MNG (17%) and 47 of 123 STN (38.2%) were associated with malignancy and the difference was statistically significant. Papillary thyroid carcinoma was the commonest malignancy observed in both the study groups. Conclusions: We conclude that the prevalence of cancer was significantly higher in STN than MNG. But, since the prevalence of malignancy in MNG was also quite high, every effort should be made to pre-operatively identify any malignant focus in patients presenting with MNG.