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Background: Thyroid nodule is probably one of the commonest endocrine problems in the world. A nodule may be solitary
thyroid nodule or dominant nodule of multinodular goiter. There has been controversy in the literature about the risk of
thyroid cancer in patients with multinodular goiter. The objective of this study was to determine the incidence and type of
thyroid carcinoma in multi-nodular goiter by doing the histopathological examination of thyroidectomy specimens.
Material & Methods: This is a prospective study, conducted in Department of ENT and Head and Neck Surgery, National
Academy of Medical Sciences Bir Hospital Kathmandu, Nepal. The study period was 5 years from 11 January 2009 to 10
January 2014. The study population consisted of 221 patients who were diagnosed as a multinodular goiter and scheduled
for surgery. Each case was studied by history taking, physical examination and relevant investigations. After surgeries the
specimens were subjected to histopathological evaluation to determine the incidence and the type of various malignancies in
multinodular goiter.
Result: The highest frequency was 104 cases (47.6%) in 31-40 years age groups. Among the total 221 cases, 76 (34.39%)
were males and 155(70.14%) females. Histopathological analysis showed that benign multinodular goiter was present in 193
(87.33%) cases and malignant thyroid lesion in 28 (12.67%) cases. Among malignancies, papillary carcinoma was found as
the commonest malignancy 22 (78.57%) cases followed by follicular carcinoma 04 (14.28%) case and anaplastic carcinoma
2(7.14%) cases.
Conclusion: The risk of malignancy in multinodular goiter should not be underestimated as significant numbers of patients
(12.67%) with thyroid malignancies present with multinodular goiter.