Malignant multinodular goitre

Multinodular goitre is a very common, and commonly benign, thyroid disorder; however variable and sometimes surprisingly high occurence of malignancy has been reported in surgical series. In this connection we retrospectively analyzed a large consecutive series of 539 thyroidectomies performed for M.N.G. over a short period of time of 3 years: there were 455 female and 84 male patients, of whom 522 over and 17 under 21 years of age. It was found an overall incidence of carcinoma of 7.5% (90.2% of papillary type), with prevalence in female (8.3%) vs male sex (3, 6%) and in patients under (11.7%) vs over (7.5%) the age of 21 years; differencies for sex and age were not significant. We remark that present revision leaved out of consideration other known factors predisposing to cancer, and included occult papillary carcinomas that are a frequent autoptic finding and do not affect life expectancy. Surgical selection, in addition to these circumstances, concurred to distort, making higher than true, the incidence of cancer in M.N.G. We conclude that M.N.G. cannot be considered as a condition predisposing to cancer but it may harbour a cancer; since that selective surgical approach is recommended. Selection criteria for surgery and treatment are mentioned.