Clinical Presentation and Outcomes of Patients Undergoing Surgery for Thyroid Cancer

To determine the clinical presentation, subtypes, and surgical outcomes of patients undergoing surgery for thyroid cancer at a tertiary care hospital in Karachi.

A case series. Place and Duration of the Study: Department of ENT Head and Neck Surgery, PNS Shifa Hospital, Karachi, Pakistan, from January 2015 to December 2024.

Patients who underwent surgery for thyroid swelling and were diagnosed with thyroid cancers through biopsy were selected. All of these patients presented with a solitary thyroid nodule; four patients with multinodular goitre but post-thyroidectomy histopathology showed malignancy. Data on demographics, FNAC categories, surgical approaches, and complications were analysed.

Among 70 patients out of 470, 11 (15.71%) were male, and 59 (84.29%) were female, with a male-to-female ratio of 1:1.53 and a mean age of 43.4 ± 8.5 years. The majority of the patients (n = 60, 85.7%) were euthyroid on initial screening preoperatively. In 7 patients, preoperative FNAC was Thy 2; therefore, the first lobectomy was performed, and upon final histopathology, completion thyroidectomy was undertaken. Papillary carcinoma was the most prevalent subtype (84.51%). Central neck dissection was performed in 62.9% of cases. Overall, positive lymph nodes were present in 23 out of 70 cases (32.8%). Complications included temporary hypocalcaemia (31.4%) and recurrent laryngeal nerve palsy (7.1%). No local or nodal recurrence was observed over the follow-up period.

Papillary thyroid carcinoma predominates among thyroid malignancies, with favourable surgical outcomes and low complication rates. Comprehensive preoperative evaluation and appropriate surgical techniques are critical for optimal outcomes.

Thyroid tumour, Thyroid malignancy, Papillary carcinoma, Follicular carcinoma, Differentiated thyroid cancer.