Incidence of Thyroid Carcinoma in Large (≥4cm) Benign Thyroid Nodules: A Retrospective Single Center Study

Objective: The purpose of our study is to see the incidence of thyroid carcinoma in large (≥4cm) Fine Needle Aspiration Cytology (FNAC) proven benign thyroid nodules. Study Design: Retrospective cross-sectional study Place & duration of Study: Department of General Surgery, Recep Tayyip Erdogan Hospital, Muzaffargarh from August 2014 to May 2021 Methodology: 238 patients with large benign thyroid nodules who underwent thyroid surgery were included in the study. The type of thyroid nodules (solitary or dominant), size of thyroid nodule (mm) and histopathology of the thyroid nodules after surgery were collected. The data was analyzed by IBM Statistical Package for Social Sciences (IBM SPSS Statistics for Windows version 20.0. Armonk, New York). Tables were constructed using Microsoft Excel 2018.  Results:  A total of 238 patients with large benign thyroid nodules were included in the study. 156 patients (65.9%) had thyroid nodule size in the range of 40mm to 50mm rest of the patients had nodule size above 50mm. The incidence of thyroid carcinoma was 14.3% (34/238). There was no significant effect of age, gender & type of thyroid nodule on risk of thyroid carcinoma. Conclusion: The risk of thyroid carcinoma in large (≥4cm) benign thyroid nodules is significant and there is a need to change our approach in their management to diagnose and manage them timely. Therefore, large (≥4cm) thyroid nodules may be considered for surgery even if preoperative FNAC is benign.