Patterns of Presentation and Surgical Management of Thyroid Swellings with Suspected Malignancy

Background: Thyroid swelling is a common clinical problem and may arise from benign or malignant conditions. Although most thyroid swellings are benign, a significant proportion may harbor malignancy, requiring timely diagnosis and appropriate surgical management. Objective: To evaluate the patterns of presentation and surgical management of thyroid swellings with suspected malignancy. Methods: This observational cross-sectional study was conducted in the Department of ENT and Head neck- surgery, Rajshahi Medical College Hospital, Rajshahi, Bangladesh from June 2014 to December 2014. A total of 50 patients with clinically and ultrasonographically diagnosed thyroid swelling who subsequently underwent thyroidectomy were included. Detailed history, clinical examination, thyroid function tests, ultrasonography, Fine Needle Aspiration Cytology (FNAC), and histopathological examination were performed. Data were analyzed using descriptive statistics. Results: The age of the patients ranged from 11 to 59 years, with the highest frequency in the 31–40 years age group (40%). Females predominated (84%), with a female to male ratio of 5.25: 1. Neck swelling was present in all patients, while dysphagia (8%), pain (6%), and dyspnoea (2%) were less common. Multinodular goitre was the most frequent type of thyroid swelling (68%), followed by solitary nodular goitre (30%). Ultrasonography revealed solid nodules in 70% cases. FNAC showed colloid goitre in 76% cases. Histopathology confirmed benign lesions in 86% and malignant lesions in 14% cases. Papillary carcinoma was the commonest malignancy (85.71%). Hemithyroidectomy was the most common surgery (60%). Conclusion: Most thyroid swellings were benign; however, a considerable proportion were malignant. Careful preoperative evaluation and appropriate surgical management are essential for early diagnosis and better outcomes.