Histopathological spectrum and frequency of thyroid carcinomas in thyroidectomy Specimens: experience from a tertiary care hospital in Karachi
DOI:
https://doi.org/10.59736/IJP.23.04.966Keywords:
Anaplasia, Histopathology, Thyroidectomy, Thyroid CancerAbstract
Background: Thyroid cancer constitutes 92% of all endocrine malignancies, and ranks as the eighth most prevalent cancer in females.
Methods: This descriptive cross-sectional study was conducted to determine the frequency and histopathological features of thyroid cancers in thyroidectomy specimens, at the Department of Histopathology, Dow University of Health Sciences, Ojha campus, Karachi. Histopathological data of 350 specimens was collected during the course of research, from June 2021 to June 2022.
Results: Of the 350 thyroidectomies, benign thyroid lesions were diagnosed in 281 (80.3%), low-risk neoplasms in 8 (2.3%) and thyroid cancer in 61 (17.4%) cases. Neck swelling was the most common presentation, followed by solitary thyroid nodule. Total thyroidectomy was the preferred type of surgery for malignant cases and benign cases with compressive symptoms. Female-to-male ratio was 6:1. Papillary thyroid carcinoma was the most frequent malignant neoplasm, diagnosed in 42 thyroidectomies (68.9%), followed by follicular and medullary carcinomas, 5 cases each (8.2%). Poorly differentiated thyroid carcinoma was documented in 2 cases and only one case of anaplastic carcinoma was reported. Most of the thyroid cancers were pathological stage T3.
Conclusion: Thyroid cancers accounted for 17.4% of all thyroidectomy cases with a strong female predominance. Papillary thyroid carcinoma was the most common type and most cases presented at pT3 stage. This emphasizes the need for thorough clinical and radiological evaluation of neck swellings to enable timely diagnosis.
References
Shruthi S, Bhat PK, Jigalur PS. Histomorphological pattern of thyroid lesions: a prospective study. Al Ameen J Med Sci. 2022;15(3):271–276.
Iqbal M, Conway S, Zhou J. Solitary thyroid nodule [Internet]. PathologyOutlines.com; 2025 [cited 2025 Oct 25]. Available from: https://www.pathologyoutlines.com/topic/thyroidsolitary.html
Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2016;26(1):1–133. doi:10.1089/thy.2015.0020
American College of Radiology. ACR Thyroid Imaging Reporting and Data System (ACR TI-RADS) [Internet]. Radiopaedia; [cited 2025 Oct 25]. Available from: https://radiopaedia.org/articles/acr-thyroid-imaging-reporting-and-data-system-acr-ti-rads
Han M, Fan F. Bethesda system for reporting thyroid cytopathology: an updated review. J Clin Transl Pathol. 2023;3(2):84–98. doi:10.14218/JCTP.2023.00005
Pizzato M, Li M, Vignat J, Laversanne M, Singh D, La Vecchia C, et al. The epidemiological landscape of thyroid cancer worldwide: GLOBOCAN estimates for incidence and mortality rates in 2020. Lancet Diabetes Endocrinol. 2022;10(4):264–272.
Qureshi MA, Mirza T, Khan S, Sikandar B, Zahid M, Aftab M, et al. Cancer patterns in Karachi (all districts), Pakistan: first results (2010–2015) from a pathology-based cancer registry. Cancer Epidemiol. 2016; 44:114–122.
WHO Classification of Tumours Editorial Board. Endocrine and neuroendocrine tumours. 5th ed. Lyon: International Agency for Research on Cancer; 2022. (WHO Classification of Tumours; Vol. 10).
Byrd DR, Brookland RK, Washington MK, Gershenwald JE, Compton CC, Hess KR, et al. AJCC cancer staging manual. 8th ed. New York: Springer; 2017.
Lloyd RV, Osamura RY, Klöppel G, Rosai J, editors. WHO classification of tumours of endocrine organs. 4th ed. Lyon: International Agency for Research on Cancer; 2017. (WHO Classification of Tumours; Vol. 10).
Juhlin CC, Mete O, Baloch ZW. The 2022 WHO classification of thyroid tumors: novel concepts in nomenclature and grading. Endocr Relat Cancer. 2023;30(2):e220293. doi:10.1530/ERC-22-0293
Akhtar ZM, Arshad M, Altaf R. Frequency of thyroid lesions at Pathology Department of King Edward Medical University, Lahore. Pak J Med Health Sci. 2022;16(3):146.
Kiran N, Adeel B, Abbasi MK, Malik AI, Aslam N, Sharif S. Histopathological characteristics and incidence of thyroid carcinoma in a tertiary care hospital of Pakistan: a retrospective study. Pak J Med Health Sci. 2023;16(12):230.
Gedamu D, Shimels T, Kassie D, Chanyalew Z, Eyasu M. Thyroid malignancy in patients who underwent thyroidectomy for multinodular goiter and solitary thyroid nodule. JCO Glob Oncol. 2024;10:e2300322.
Doubi A, Al-Qannass A, Al-Angari SS, Al-Qahtani KH, Alessa M, Al-Dhahri S. Trends in thyroid carcinoma among thyroidectomy patients: a 12-year multicenter study. Ann Saudi Med. 2019;39(5):345–349. doi:10.5144/0256-4947.2019.345
U PS, Kuruwatti A, V S, H J. Histomorphological study of thyroidectomy specimens in a tertiary care hospital: a retrospective study. Indian J Otolaryngol Head Neck Surg. 2023;75(4):3205–3210. doi:10.1007/s12070-023-03916-w
Qureshi IA, Khabaz MN, Baig M, Begum B, Abdelrehaman AS, Hussain MB. Histopathological findings in goiter: a review of 624 thyroidectomies. Neuroendocrinol Lett. 2015;36(1):48–52.
Sunday-Nweke N, Nwoye C, Icheku S, Udu U, Enemuo V, Oboke O, et al. Frequency of thyroid malignancy and surgical outcomes in a private low-resource center: a retrospective study. Asian J Med Health. 2025;23(5):68–74
Hu S, Wu X, Jiang H. Trends and projections of the global burden of thyroid cancer from 1990 to 2030. J Glob Health. 2024; 14:04012.
Li M, Zheng R, Dal Maso L, Zhang S, Wei W, Vaccarella S. Mapping overdiagnosis of thyroid cancer in China. Lancet Diabetes Endocrinol. 2021;9(6):330–332.
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