Clinico-Pathological Presentation and Management Outcome of Thyroid Diseases at a Tertiary Medical Centre in North-central Nigeria

Abstract

Thyroid diseases are endemic in our environment. These could be benign or malignant in nature. Management of thyroid diseases is multidisciplinary with attendant complications observed with operative treatment. This study looked at the spectrum and appraises the management of thyroid diseases encountered at the study centre. This is a 6-year retrospective descriptive study that looked at the various forms of thyroid diseases that were managed at FMC Keffi from January 2015 to December 2020. Patients' pathological details were retrieved from the histopathology Departmental records as well as patients' folders covering the said period. Data obtained was analysed with Epi Info statistical package version 3.5.1. A total of 116 patients were reviewed out of which 79 (68.1%) patients had operative treatment. Their ages ranged between 18-72 years (mean age 33.5±3.01years). A hundred and seven (92.2%) were females while 9 (7.8%) were males with M:F of 1: 12. Benign thyroid diseases were common 89(76.7%) with non-toxic goiters accounting for more than two-thirds 51 (57.3%) while the rest were toxic 38 (42.7%)). Papillary thyroid carcinoma was the commonest malignant variant 13(48.2%) followed by follicular 7(25.9%), anaplastic 5(18.5%) and medullary 2(7.4%) variants. Total thyroidectomy was the most common procedure carried out on the patients 42 (53.2%) followed by sub-total thyroidectomy 22(27.9%). Complications encountered included dysphonia 11 (13.9%), respiratory distress from deep space haematoma 5(6.3%), recurrent laryngeal nerve injury 6 (7.6%), and hypocalcaemia 3 (3.8%). Thyroid diseases are common encounters with variations in pathology. Papillary thyroid cancer was found predominant among differentiated thyroid cancers. Recurrent laryneal nerve injury is a recognized complication that may ensue especially in inflammatory, recurrent or toxic goitres. A better approach to a successful management of thyroid diseases is multidisciplinary with adequate understanding of the anatomy, pathology and possible operative outcomes.