Occult Thyroid Carcinoma Incidence in Multinodular Goiter Experience of a Medium-Volume Center in Romania

Background: Multinodular goiter (MNG) is a common thyroid condition characterized by multiple nodules within the thyroid gland. This study aims to evaluate the incidence and clinical features of occult thyroid carcinoma in patients with multinodular goiter, based on the experience from a medium-volume cancer center. Methods: A retrospective analysis was conducted on patients diagnosed with multinodular goiter who underwent thyroidectomy. Clinical, radiological, and histopathological data were reviewed to identify cases of occult thyroid carcinoma. Factors such as age, sex, and histopathological characteristics were analyzed to determine potential risk factors for malignancy in this cohort. Results: A total of 332 patients with MNG were included in the study, with 61 (17.5%) diagnosed with occult thyroid carcinoma. The incidence of occult carcinoma was more frequent in females, with a notable predilection for papillary carcinoma. Regarding age, occult tumors were more frequently encountered in the 20–40 age group, irrespective of gender. Conclusions: In conclusion, we observed that in our center over a 6-year period, the incidence of thyroid cancer after total thyroidectomy for multinodular goiter sits at 17.5%. Thyroid diseases are more frequent in women, which in turn leads to an increased rate of occult carcinomas. Up to 70% of the cancers were papillary. The clinical risk factors associated with a higher probability of cancer were lower age and female gender.