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      Thyroid malignancy in endemic nodular goitres: prevalence, pattern and treatment.

      European Journal of Surgical Oncology
      Adolescent, Adult, Aged, Child, Female, Goiter, Endemic, complications, Goiter, Nodular, Humans, Iodine, deficiency, Male, Middle Aged, Prevalence, Thyroid Neoplasms, diagnosis, epidemiology, surgery, Thyroidectomy, Treatment Outcome

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          Abstract

          The epidemiology of thyroid cancers in goitre endemic zones has not been recently reviewed, and changes being currently reported have been from studies in non-endemic areas. The aims of this study were to present the clinical pattern of thyroid malignancy in a goitre endemic area and identify recent changes, if any. The study was conducted at Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria between January 1983 and December 1993. Records of patients with nodular goitres treated with thyroidectomy were reviewed, and the clinical features, laboratory parameters, treatment, outcome and follow-up of histologically-proven malignant cases were studied. Thirty-six of 279 (12.9%) patients, aged 13-85 years (mean)=43.7+/-14.7 years), carried malignant goitres, and most (80%) were young or middle-aged women. Of the well-differentiated cancers, follicular type was the most prevalent, being six- and 12-fold as frequent as papillary and medullary cancers (69%vs 11% and 5.6%), respectively. Lymphoma accounted for 5.6%, fibrosarcoma, 5.6% and anaplastic, 2.8%. No relationship was demonstrable between cancer type, duration of goitre and age at diagnosis (r=0.06 and 0.17, respectively). Thyroid cancers afflict comparatively young women in our environment, and follicular cancer remains the predominant type, partly as a result of persisting dietary iodine deficiency. Copyright Harcourt Publishers Limited.

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