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Carcinoma of the thyroid in black patients
M E Brooks1, N Rogers, R Ransome
1Department of Pathology, Howard University Hospital, Washington, DC.
Insights
Thyroid carcinoma is rare in Black patients, often leading to delayed diagnosis and advanced disease. Maintaining a high index of suspicion for thyroid nodules is crucial for early detection and improved outcomes.
Area of Science:
- Oncology
- Epidemiology
Background:
- Thyroid carcinoma is uncommon in Black patients.
- Rarity can lead to delayed diagnosis and advanced disease presentation.
Purpose of the Study:
- To review the characteristics and treatment of thyroid carcinoma in Black patients.
- To highlight the importance of early diagnosis and high index of suspicion.
Main Methods:
- Retrospective chart review of 33 thyroid carcinoma patients (1976-1988).
- Exclusion of non-Black patients, focusing on 30 Black patients.
- Analysis of patient demographics, histology, and disease stage at diagnosis.
Main Results:
- The study included 30 Black patients (19 female, 11 male).
- Histological types included papillary, follicular variant, follicular, undifferentiated (anaplastic), and medullary.
- Ten patients presented with distant metastasis or locally advanced disease.
Conclusions:
- Thyroid carcinoma requires a high index of suspicion in Black patients due to its rarity.
- Prompt diagnosis and appropriate management are essential for better patient outcomes.
- Early detection of thyroid nodules can prevent advanced disease stages.
Abstract:
In the period from January 1, 1976 to December 31, 1988, we reviewed the charts of 33 patients treated for carcinoma of the thyroid at Howard University Hospital. The three non-black patients (two Whites and one Pakistani) were excluded from the study. There were 19 females and 11 males. Of the 30 cases elevated, 10 were papillary, 7 were follicular variant of papillary, 8 were follicular, 3 were undifferentiated (anaplastic), and 2 were medullary. Ten patients had either distant metastasis (Hoffman, South Med J 80:741, 1987) or locally advanced disease in the neck (Woolner et al., Am J Surg 102:354, 1961.) at the time of diagnosis. The treatment of these lesions depended on, among other variables, the cell type, the extent of the lesion, and the personal preference of the attending surgeon. Carcinoma of the thyroid remains an uncommon lesion in Black patients. Because of its rarity, the diagnosis may often be delayed and, as a result, patients may first come to attention with a more advanced stage of this disease. To prevent this occurrence, a high index of suspicion must be maintained for all thyroid nodules, and appropriate diagnostic steps taken. Diagnostic and treatment options are discussed.