Thyroid malignancy in multinodular goitre and solitary nodule

This is a retrospective study of 361 thyroid specimens during a 6 1/2-year period with the objective of investigating the prevalence and pattern of thyroid malignancy associated with multinodular goitre (MNG) and solitary nodule (SN). Fourteen of 172 MNG (8%) and 16 of 105 SN (15.2%) were associated with malignancy, a statistically insignificant difference (P = 0.06). Unlike in males, malignancy was significantly commoner in females with SN than those with MNG (P = 0.03) and generally occurred at a significantly older age (P < 0.05). On analysing thyroid carcinoma and lymphoma separately, patients with SN had a higher incidence of carcinoma compared with those with MNG (P = 0.01). It is concluded that surgical intervention may be the appropriate method of treating male patients presenting with MNG. However, in females, conservative management of MNG should be adopted unless surgery is indicated depending on clinical judgement and, if feasible, the result of fine needle aspiration biopsy.