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Incidental Thyroid Carcinoma in Patients Treated Surgically for Thyroid Disease

Background: The occurrence of incidental thyroid cancer (ITC) has increased by three times during the last decades and this rise could be attributed to many factors. To limit the prevalence of ITC with goiter especially nodular goiter, total thyroidectomy can become a procedure of choice.

Objective: To determine the extent of incidental thyroid carcinoma (ITC) and to plan a proper preoperative diagnostic work up and a convenient operative procedure for patients with different thyroid diseases.


Results:
ITC was found in 77 patients (19.15%). While, 63 patients with non-toxic MNG (15.6%), 12 patients with non-toxic solitary thyroid nodule (3%) and two patients (0.5%) with toxic MNG were observed in the study. Out of 77 patients with ITC, 56(72.7%) were ˂45 years and the remaining 21 (27.3%) ≥45 years. The 15 patients were males and 62 patients were females in these groups.

Material and Methods: A prospective study was conducted during the period from October 2013 to October 2016 at Baghdad teaching hospital (main tertiary hospital in Iraq), first surgical unit by a single surgeon and his trainees. The study included 473 patients who were referred for surgical treatment of different thyroid diseases. About 71 patients were excluded from the study due to the diagnosis of malignancy (MNG) by FNAC or history of surgery. The remaining 402 patients were evaluated for the presence of the cancer by post-operative pathological examination.

Conclusions: Although ITC in this study is relatively high especially in MNG; a more radical surgical treatment seems needed in the management of patients with presumably benign thyroid disease. The authors identify a potential benefit in performing total thyroidectomy instead of near or subtotal when considering management of MNG.

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Publication Date
Sun Oct 02 2016
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Incidental thyroid carcinoma

Background: thyroid carcinoma is the most common endocrine carcinoma as it accounts for almost 90% of all endocrine malignancies. The term incidental denoted malignant tumors of the thyroid gland detected by post-operative biopsy results of the resected specimens resected from benign thyroid diseases. Among the incidental thyroid malignancies, papillary carcinoma is the commonest pathological type.
Objectives : To determine the incidence of incidental thyroid carcinoma and to insist on accurate preoperative diagnostic work up of patients with thyroid diseases.
Patients & Methods: A prospective study, which was conducted during the period from March 2013 to April 2014 at Baghdad teaching hospital first surgical unit by the same

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Publication Date
Sun Sep 02 2018
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Immunohistochemistry on cell blocks a method for pre-operative diagnosis of papillary thyroid carcinoma by FNAC

Background: Papillary thyroid carcinoma (PTC) is the commonest thyroid cancer. Cases in category-
5a of Bethesda system (suspicious for papillary carcinoma) are treated by surgical lobectomy followed
by total thyroidectomy if histopathology confirms papillary carcinoma. In order to reduce surgical
procedures to one this was conducted.
Objectives: evaluation of role of immunohistochemistry in pre-operative diagnosis of papillary thyroid
carcinoma on cell blocks.
Materials and Method: Cell blocks were taken from cases labelled category-5a for histopathology and
immunohistochemistry using three markers (CK-19, Thyro-peroxidase, and BRAFv600E mutation).
Results: were highly sensitive, and specific. The use of more tha

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Publication Date
Sun Oct 01 2017
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Pre-operative serum TSH level estimation for predicting malignant nodular thyroid disease

Background: the aim of this study was to assess the value of serum thyroid–stimulating hormone (TSH) levels in predicting malignancy in patients with nodular thyroid disease (NTD). Objective: The aim was to examine the relationship between preoperative TSH and differentiated thyroid cancer (DTC).
Patients and Method: all patients with NTD who were admitted in the first surgical unit of Baghdad teaching hospital and assessed for preoperative TSH level before subjecting them for thyroidectomy from first of April 2014 to 31 of January 2016, were included in the study. A preoperative database sheets including Age, gender, nodule size, and pathology were evaluated. Logistic regression analysis was used t

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Publication Date
Wed Apr 15 2020
Journal Name
Journal Of The Faculty Of Medicine Baghdad
collision tumor of thyroid gland a case report

collision tumor is the presence of two histopathologically distinct tumors in the same anatomical site.  It is a rare pathology of the thyroid gland that makes diagnosis and treatment challenging.  This is a case report of a collision tumor of the thyroid gland.

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Publication Date
Fri Mar 01 2024
Journal Name
Baghdad Science Journal
Exploring the Challenges of Diagnosing Thyroid Disease with Imbalanced Data and Machine Learning: A Systematic Literature Review

Thyroid disease is a common disease affecting millions worldwide. Early diagnosis and treatment of thyroid disease can help prevent more serious complications and improve long-term health outcomes. However, thyroid disease diagnosis can be challenging due to its variable symptoms and limited diagnostic tests. By processing enormous amounts of data and seeing trends that may not be immediately evident to human doctors, Machine Learning (ML) algorithms may be capable of increasing the accuracy with which thyroid disease is diagnosed. This study seeks to discover the most recent ML-based and data-driven developments and strategies for diagnosing thyroid disease while considering the challenges associated with imbalanced data in thyroid dise

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Publication Date
Sun Nov 08 2020
Journal Name
Journal Of The Faculty Of Medicine Baghdad
the The Role of Ultrasound in the Diagnosis of Malignant Thyroid Nodules

Background: Thyroid nodules are very common in clinical practice. Although most of thyroid nodules are benign, it is crucial to checkout which nodules are more likely to be malignant. Ultrasound is a major diagnostic tool for screening and evaluating thyroid diseases because it is safe, non-invasive, non-radioactive and effective.
Objective: The aim is to identify the role of ultrasound in assessing thyroid nodules and to review various ultrasound criteria predicting malignancy.
Patients and methods: A case series study conducted during the period from January 2015 to February 2016 at the First Surgical Unit, Department of Surgery, Baghdad Teaching Hospital by a team of surgeons. One hundred eighty Patients who underwent surgical i

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Publication Date
Tue Jul 01 2014
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Effect of thyroid dysfunction on hemoglobin A1c in polycystic ovary patients during ovulation induction trials.

Background: Polycystic ovary syndrome (PCOS) is one of the most common female endocrine disorders leading to infertility. Majority of women with PCOS have insulin resistance and elevated hemoglobin A1c.The presence of thyroid dysfunction may affect the levels of HbA1c and the results of ovulation induction programs.                                                                    &nbsp

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Publication Date
Sun Apr 03 2016
Journal Name
Journal Of The Faculty Of Medicine Baghdad
The incidence of thyroid malignancy in multinodulargoiter in Alkindy teaching hospital.

Back ground: The incidence of malignancy in multi-nodular goiter is thought to be low as compared with solitary thyroid nodule.
Objectives: Identifying incidence of malignancy in multi-nodular goiter.
Patients and Methods: This is a prospective study at Al-kindy teaching hospital from January 2013 to September 2015. 160 patient with multi-nodular goiter were included in the study (132females,28 males)  their ages ranged between 17-75 years with a mean age of 35.88 years. Each of the patients had special form of detailed information including history and physical examination ,results of investigations; all the patients had near total thyroidectomy. All the specimens were fixed in formalin and sent for histo-pathological evaluat

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Publication Date
Sun Jun 20 2021
Journal Name
Baghdad Science Journal
Hypothyroidism and Leptin in Iraqi Patients with Chronic Kidney Disease

The present study aims at assessing the effects of chronic kidney disease (CKD) on thyroid hormone and leptin by evaluating the level of: leptin hormone along with thyroid hormone in CKD patients. The study has been conducted on  70 subjects, 50 patients with an age range between 20-50 years (25  males and 25 females) who were diagnosed to have CKD stage-5, and 20 normal controls whose ages ranged between 20-48 years (10  males and 10 females), who attended  the Nephrology and Transplant Center in Medical City of Baghdad- Iraq from April  2018  to July  2018. The study showed a highly significant (P<0.01) increase in TSH level in CKD patients in comparison with controls. While T3 and T4 levels observed highly significant decrea

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Publication Date
Wed Oct 01 2014
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Spiro metric Tests and Thyroid Hormone Concentrations in sample of Iraqi Patients with Chronic Obstructive Pulmonary Disease.

Background: Chronic obstructive pulmonary disease (COPD) is a preventable disease with some significant extra pulmonary effects that may contribute to the severity in individual patients.. The systemic manifestations  of  COPD  include  a number of endocrine disorders , such  as  those  involving the pituitary, the thyroid , the gonads, the adrenals  and  the pancreas.  The  mechanisms  by which COPD  alters  endocrine function are incompletely understood  but likely involve  hypoxemia , hypercapnia , systemic inflammation and  glucocorticoid  administration.

Objective:  To evaluate the relationship bet

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