The incidence of Thyroid Carcinoma in Solitary Cold Nodules and in Multinodular Goiter

ABSTRACT

The management of thyroid nodules, about which widely differing views have been expressed for many years, is still a controversial subject. The primary reason for concern about thyroid nodules is that they might be malignant.The incidence of carcinoma in patients with multinodular goiters has reported to be considerably lower than in patients with a single nodule. In this retrospective study of 510 cases of thyroidectomies over a 14-year period, 151 patients with factors predisposing them to neoplasia, such as Grave's disease and thyroiditis, were eliminated. The remaining 93 patients with clinically evident multinodular goiters were compared with remaining the 226 patients with a solitary cold nodule. The incidence of carcinoma in the 266 patients with a solitary cold nodule was 15.4%. In the 93 patients with clinically evident multinodular goiters, the incidence of carcinoma was 18.3%. The difference is not significant. It is of interest that male patients with multinodular goiters had the highest incidence of carcinoma at 25.0%, whereas, males with a solitary cold nodule had an incidence of only 17.9%. In conclusion, once known factors that predispose patients to neoplasia are eliminated, there does not seem to be a significant difference in the incidence of thyroid carcinoma between patients with operatively and histopathologically proved solitary cold nodules and those with multinodular goiter.