RESUMEN
I. To determine the frequency of malignancy in multi nodular goiter. II. To determine the histopathological types. This is a prospective study. Surgical department of Foundation Hospital Rawalpindi and associated Teaching Hospital of Frontier Medical College Abbottabad. Aug. 2002 to Aug. 2007. One hundred patients with Multi nodular were included in this study. Patient with diffuse goiter, solitary nodules, patient operated somewhere else and suspected cases of malignancy were excluded from the study. Tissue were sent to Armed Force Institute for histopathological examination. Patients were followed for 2 weeks after surgery with histopathological report, all the preoperative and postoperative findings were recorded in detail. Data was analyzed byusing SPSS 14. Majority of patients studied, belonged to Azad Kashmir and Gilgit which are among the known endemic regions for goitre in Pakistan and other from Chakwal and Jhelum. Histopathology revealed 96 [96%] patients with multi nodular goiter, 3 [3%] papillary carcinoma and 1 [1%] Follicular carcinoma. Multinodularity of the goitre should not be considered as low risk of malignancy and delay for surgical intervention. Changes in the size of gland, the appearance of new and hard nodules or cervical lymphadenopathy may indicate malignant change and prompt indication for surgery