Occult Thyroid Carcinoma: A Tertiary Hospital Experience in Ibadan, Nigeria
Carcinoma de tiroides oculto: una experiencia en un hospital terciario en Ibadan, Nigeria
Adefemi Oladiran Afolabi, Bamidele Johnson Alegbeleye, Naomi Olagunju
Abstract
Introduction: There is a dearth of knowledge on the proportion that occult thyroid carcinoma constitutes amongst patients with thyroid cancer in our practice. This study was therefore conducted to review the cases of occult thyroid carcinoma with a focus on the presentation, management, and the outcome of care in a low resource tertiary hospital setting.
Materials and Methods: We conducted a retrospective cross-sectional descriptive study of 62 patients who were managed for thyroid cancer over a 15-year-period at the University College Hospital, Ibadan, Nigeria. The patients who had more than two follow-up visits to the Thyroid Clinic, over the preceding fifteen years were included in this study. The types of surgeries performed on the patients were noted. The data were analyzed using descriptive statistics. We also identified the various limitations that might have hindered the effective care of such patients.
Results: Sixty-two consecutive patients, 12 male (19.4%) and 50 females (80.6%) with a median interquartile age range of 45 years, were diagnosed with thyroid cancer. The surgeries performed on the patients were total thyroidectomy, 48 (77.4%), completion-thyroidectomy, 14 (22.6%), near total thyroidectomy, etc. Occult thyroid cancer constituted 38 (61.3%) of the patients managed for thyroid cancer. The most common histology subtype was papillary carcinoma. We identified late presentation, inadequate oncologic surgery, financial constraint etc., as limitations of optimal care.
Conclusions: In view of the proportion of occult thyroid cancer in this cohort of patients, the clinically benign goitres might contain carcinoma or micro-carcinoma. Therefore, an aggressive public health campaign to encourage early presentation of our patients and primary reduction through total thyroidectomy is recommended to improve the outcome of care.
Keywords
Resumen
Introducción: Existe una escasez de conocimiento sobre la proporción que constituye el carcinoma de tiroides oculto entre los pacientes con cáncer de tiroides en nuestra práctica. Por lo tanto, este estudio se realizó para revisar los casos de carcinoma de tiroides oculto con un enfoque en la presentación, el manejo y el resultado de la atención en un entorno hospitalario terciario de bajos recursos.
Materiales y Métodos: Realizamos un estudio descriptivo transversal retrospectivo de 62 pacientes que fueron tratados por cáncer de tiroides durante un período de 15 años en el University College Hospital, Ibadan, Nigeria. Se incluyeron en este estudio los pacientes que tuvieron más de dos visitas de seguimiento al centro durante los quince años anteriores. Se anotaron los tipos de cirugías realizadas a los pacientes. Los datos se analizaron mediante estadística descriptiva. También identificamos las diversas limitaciones que podrían haber obstaculizado la atención eficaz de estos pacientes.
Resultados: Sesenta y dos pacientes consecutivos, 12 hombres (19,4%) y 50 mujeres (80,6%) con una mediana de edad intercuartil de 45 años, fueron diagnosticados de cáncer de tiroides. Las cirugías realizadas a los pacientes fueron tiroidectomía total, 48 (77,4%), tiroidectomía completa, 14 (22,6%), tiroidectomía casi total, etc. El cáncer de tiroides oculto constituyó 38 (61,3%) de los pacientes tratados por cáncer de tiroides. El subtipo histológico más común fue el carcinoma papilar. Identificamos la presentación tardía, la cirugía oncológica inadecuada, la restricción financiera, etc., como limitaciones de la atención óptima.
Conclusiones: Dada la proporción de cáncer de tiroides oculto en esta cohorte de pacientes, los bocios clínicamente benignos pueden contener carcinoma o microcarcinoma. Por lo tanto, se recomienda una agresiva campaña de salud pública para fomentar la presentación temprana de nuestros pacientes y la reducción primaria mediante tiroidectomía total para mejorar el resultado de la atención.
Palabras clave
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Submitted date:
04/18/2021
Reviewed date:
04/26/2021
Accepted date:
05/21/2021
Publication date:
05/21/2021
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