Clinicopathological spectrum of thyroid lesions: Insights from a 5-year retrospective audit at a north Indian tertiary center

Background: Thyroid disorders form a major share of endocrine disease in India and exhibit wide regional variation in incidence and morphology. Histopathological examination of thyroidectomy specimens remains the diagnostic gold standard and guides surgical management. Objective: The objective of this study was to analyze the clinicopathological spectrum of thyroid lesions over 5 years at a North Indian tertiary center and compare demographic and morphological trends with published Indian data. Materials and Methods: A retrospective audit of 117 thyroidectomy and lobectomy specimens (January 2020–December 2024) was conducted. Demographic profile, histological subtype, lesion size, and laterality were recorded. Descriptive statistics were applied; associations between lesion type, age, and gender were assessed with Chi-square (P < 0.05 significant). Results: Mean age 48.4 ± 13.2 years (17–78); 79.5% female. Benign lesions 80.3%, predominantly multinodular goiter (56.4%), colloid goiter (25.5%), and thyroiditis (10.6%). Malignancies 19.7%, mostly papillary carcinoma (87%), similar to previous Indian series. Malignancy correlated with age >45 years (P = 0.03). Mean lesion size 6.37 cm overall, 5.10 cm in malignant cases. Conclusion: Multinodular goiter remains the most frequent lesion, whereas papillary carcinoma predominates among malignancies. Larger tumor size and higher malignancy proportion than Western reports reflect delayed presentation and highlight the need for early evaluation and awareness programs.