Epidemiology, spectrum, and pathology of surgical thyroid resections in a metropolitan South African setting

Abstract

Background: Nodular thyroid disease is a common condition worldwide, and its prevalence is increasing. Surgical thyroid pathology includes non-neoplastic and neoplastic conditions. Patients may present with various thyroid pathologies. Given the multifactorial risk factors associated with these pathologies, such as age, gender, iodine deficiency, and prior radiation exposure, it is essential to understand the patient profile for each condition.

Objectives: This study aimed to describe the epidemiology, spectrum, and proportion of thyroid pathologies in patients who underwent thyroid resection in a metropolitan area in South Africa. It also examined the predisposing factors, types of surgeries performed, and their indications. Local and global statistics were compared to provide a broader understanding of the epidemiology, proportion, and spectrum of surgical thyroid pathology.

Methods: This study retrospectively examined 444 cases of thyroid resections that were performed at Chris Hani Baragwanath Academic Hospital over an eight-year period. Microscopic slide review was performed for 12% of the cases, which included at least one example of each diagnosis.

Results: A significant female predominance (91%) was noted. Thyroid pathologies affected a wide age range, with a mean of 48.26 years (standard deviation = 12.44). Amongst non-neoplastic conditions, nodular hyperplasia (48.87%) was the most common. The most common benign neoplasm was follicular adenoma (6.53%) and papillary thyroid carcinoma (29.05%) was the most prevalent malignancy. The study identified various papillary thyroid carcinoma (PTC) subtypes.

Conclusion: This study provides valuable insights into the epidemiology, spectrum, and pathology of non-neoplastic and neoplastic thyroid pathologies in a South African metropolitan setting.