Thyroid cancers in nodular goiters in Kano, Nigeria.

BACKGROUND Cancer is an occasional incidental finding in nodular goiter, but there has been no formal study on this disease in our locality. AIMS AND OBJECTIVES To determine the occurrence of histologically diagnosed malignancy in patients who present with nodular goiters. METHODOLOGY This is a 7-year (2000-2006) retrospective study of all histologically diagnosed malignancies within nodular goiters at Aminu Kano Teaching Hospital, Kano. RESULTS There were 160 multinodular goiters during the study period, out of which 24 (15.0%) had histologically diagnosed cancer, and 1 out of the thirteen patients with solitary thyroid nodule (7.6%) had carcinoma. The ages of the patients with carcinoma ranged from 16 to 65 years, with a mean age of 38.8 years. Eighteen (72%) were females, and 7 (28%) were males. Six out of the 25 cases of carcinoma were detected preoperatively by fine needle aspiration cytology. Well differentiated follicular carcinoma was the predominant histological type in 13 (52%) cases, followed by papillary in 10 (40%), medullary carcinoma in 1 (4%) and anaplastic carcinoma in 1 (4%) patient. CONCLUSION One-seventh of nodular goiters in our center harboured malignancy, and follicular carcinoma was the prevalent histological type. This is consistent with the findings elsewhere in endemic goitrous regions. Ultrasound guided fine needle aspiration would improve preoperative diagnosis and guide appropriate surgical management.