Incidental Thyroid Malignancy in Surgical Patients With Benign Thyroid Disease

Area of Science:

• Endocrinology
• Oncology
• Pathology

Background:

• The incidence of incidental thyroid malignancy (ITM) has risen, yet contributing factors remain unclear.
• This study investigates ITM rates in patients with benign thyroid disease (BTD) without prior cancer suspicion.

Purpose of the Study:

• To determine the rate of ITM in patients undergoing thyroidectomy for BTD.
• To identify sociodemographic and clinical factors associated with ITM.

Main Methods:

• Retrospective analysis of prospectively collected data from 2528 patients (2011-2022).
• Included 345 patients with BTD, excluding those with known thyroid cancer, radiation exposure, or suspicious preoperative findings.
• Analyzed ITM rate against demographics, BMI, tumor size, and invasive features.

Main Results:

• ITM was detected in 22.9% of patients with BTD.
• Higher BMI was a significant predictor of increased ITM rate (OR=1.057, P=0.007).
• Nontoxic multinodular goiter showed the highest ITM incidence (36.0%); other factors were not significantly associated.

Conclusions:

• A higher-than-reported rate of ITM was observed.
• An association between elevated BMI and ITM suggests a potential link between obesity and thyroid malignancy.
• Patients with BTD and higher BMI may warrant closer surveillance.