Muhammad Abdullah1. 1. Department of Surgery, University Hospital, Kuala Lumpur, Malaysia. mabdullah@ummc.edu.my
Abstract
BACKGROUND: There have been few detailed studies on thyroid cancer (TC) in Malaysia, a multiethnic country with three major races - Malays, Chinese and Indians. METHODS: The paper retrospectively audits the records of 107 consecutive cases with histologically proven thyroid cancer between 1995 and 2000 presenting to University Hospital, Kuala Lumpur. The demographic distribution, histological variants, mode of presentation, sensitivity of fine needle aspiration cytology and the modalities of treatment are examined in the present paper. RESULTS: Of a total of 107 cases of TC, 74 were papillary, 23 follicular, one Hurthle Cell, seven medullary and two anaplastic. There were 91 women and 16 men; the corresponding median age of presentation being 34.0 and 40.0 years. The median age at presentation of TC was 36 years in the Malay population, 37 in the Chinese population and 33 in the Indian population. Fifty-six per cent of follicular cancer incidence was in the Malay population alone, the remaining in the other populations. Solitary thyroid nodule was seen in 75 patients, generalized enlargement in 20 and no goiter in 11. Local symptoms were reported in <10% of patients. Preoperative FNAC had a sensitivity of 72.26%. Of 98 patients with well-differentiated TC (WDTC), total thyroidectomy was employed in 92. Surgery alone was used in 48 cases and combined with radioactive iodine ablation in the remaining 50. CONCLUSION: All histological variants of TC are represented in the study. Well-differentiated TC forms the bulk with papillary cancer having the largest percentage. Follicular cancer is more common in the Malay population. Total thyroidectomy in WDTC, although controversial, remains the mainstay of surgical treatment in Malaysia.
BACKGROUND: There have been few detailed studies on thyroid cancer (TC) in Malaysia, a multiethnic country with three major races - Malays, Chinese and Indians. METHODS: The paper retrospectively audits the records of 107 consecutive cases with histologically proven thyroid cancer between 1995 and 2000 presenting to University Hospital, Kuala Lumpur. The demographic distribution, histological variants, mode of presentation, sensitivity of fine needle aspiration cytology and the modalities of treatment are examined in the present paper. RESULTS: Of a total of 107 cases of TC, 74 were papillary, 23 follicular, one Hurthle Cell, seven medullary and two anaplastic. There were 91 women and 16 men; the corresponding median age of presentation being 34.0 and 40.0 years. The median age at presentation of TC was 36 years in the Malay population, 37 in the Chinese population and 33 in the Indian population. Fifty-six per cent of follicular cancer incidence was in the Malay population alone, the remaining in the other populations. Solitary thyroid nodule was seen in 75 patients, generalized enlargement in 20 and no goiter in 11. Local symptoms were reported in <10% of patients. Preoperative FNAC had a sensitivity of 72.26%. Of 98 patients with well-differentiated TC (WDTC), total thyroidectomy was employed in 92. Surgery alone was used in 48 cases and combined with radioactive iodine ablation in the remaining 50. CONCLUSION: All histological variants of TC are represented in the study. Well-differentiated TC forms the bulk with papillary cancer having the largest percentage. Follicular cancer is more common in the Malay population. Total thyroidectomy in WDTC, although controversial, remains the mainstay of surgical treatment in Malaysia.