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Risk of neoplasia and malignancy in "dominant" thyroid swellings
E L Cusick1, Z H Krukowski, C A MacIntosh
1Department of Surgery, University of Aberdeen.
Objective:
To determine the risk of neoplasia and malignancy in "dominant" thyroid swellings.
Design:
Prospective analysis during six years.
Setting:
Thyroid clinic serving the Grampian region.
Patients:
574 consecutive patients presenting with a discrete thyroid swelling, of whom 179 (31%) were classified clinically as having a dominant area of enlargement within a multinodular gland.
Results:
After clinical and cytological assessment 77 dominant swellings were excised. Of the excised swellings, 45 were non-neoplastic and 32 neoplastic, including 11 malignant lesions. The minimum incidence of neoplasia and malignancy in all 179 dominant swellings was therefore 18% and 6% respectively.
Conclusion:
Dominant thyroid swellings should be regarded with greater clinical suspicion than has been traditional.
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