Bitlis İlinde Nodüler Guatr Nedeniyle Tiroidektomi Uygulanan Hastalarda Tiroid Kanseri İnsidansı

Amaç: Tiroid maligniteleri en sık görülen endokrin kanserlerdir. Tüm malignitelerin %1'ni oluştururlar. Bu çalışmanın amacı, endemik guatr bölgesi olan Bitlis ilinde tek cerrah tarafından tiroidektomi yapılan nodüler guatr olgularında, tiroid kanseri görülme sıklığını araştırmaktır. Gereç ve Yöntem: Bitlis Devlet Hastanesinde, Eylül 2008 ve Mart 2015 tarihleri arasında nodüler guatr ön tanısıyla cerrahi endikasyonu konulan ve tek cerrah tarafından tiroidektomi yapılan toplam 940 hastanın patoloji raporları retrospektif olarak tarandı. Postoperatif histopatolojik bulgular değerlendirildi. Bulgular: Hastalarımızın 827'si (%88) kadın, 113'ü (%12) erkek olup, kadın/erkek oranı 7,3/1 idi. Toplam 940 hastanın 30' una (%3,2) bir taraf total + diğer taraf totale yakın, 910' nuna (%96,8) bilateral total tiroidektomi uygulandı. Histopatolojik incelemede 825 (%87,7) olguda nodüler hiperplazi, 46 (%4,9) olguda lenfositik tiroidit, 69 (%7,3) olguda ise tiroid tümörü tespit edildi. 69 tümör olgusunun 18' i (%26) benign, 51' i (%74) ise malign idi. Kanser tipi olarak 45 (%4,7) olguda papiller karsinom, 5 (%0,5) olguda folliküler karsinom, 1 (%0,1) olguda ise medüller karsinom tespit edildi. Sonuç: Endemik guatr bölgelerinde, ekzojen iyot alınması bazı olgularda tiroid dokusu morfolojisinde değişime neden olarak sitolojik sonuçları etkileyebilmektedir. Bitlis ilinde tiroidektomi yapılan nodüler guatr olgularında tiroid kanseri görülme sıklığı %5,4 olarak tespit edilmiş olup, en fazla kanser tipi olarak papiller tiroid karsinomu görülmektedir.

Incidence of Thyroid Carcinoma in Patients Undergoing Thyroidectomy for Nodular Goiter in Bitlis Province

Objective: The most frequently observed endocrine cancer is thyroid malignity. Itconstitutes only one percent of all malignities. The aim of this study is to investigate theincidence of thyroid cancer in cases with nodular goiter who undrewent thyroidectomyperformed by a single surgeon in Bitlis province (Turkey), an endemic goiter region.Materials and Methods: Pathology reports with surgery indication of 940 patients, whounderwent thyroidectomy administered by the same surgeon for nodular goiter at BitlisState Hospital between September 2008 and March 2015, were studied retrospectively.Postoperative histopathologic examinations were evaluated.Results: Female and male counts of our 940 patients were 827 (88%) and 113 (12%),respectively. The proportion of female to male patients was 7,3/1. 30 of 940 patients(3,2%) underwent one part total and the other part near total thyroidectomy and 910patients (96,8%) underwent total thyroidectomy. Histopathological examination showedthat 825 (87,7%) cases had nodular hyperplasia, 46 (4,9%) cases had lymphocyticthyroiditis, and 69 (7,3%) cases had thyroid tumors. 69 tumors in 18 (26%) cases werebenign; 51 (74%) cases were malign. In terms of cancer type, 45 (4,7%) cases had papillarycarcinoma, 5 (0,5%) cases had follicular carcinoma, and 1 (0,1%) case had medullarycarcinoma.Conclusion: In some cases in endemic goiter regions, received exogenous iodine canaffect cytological results and cause changes in thyroid tissue morphology. The observedincidence of thyroid cancer was 5,4% in the cases who underwent thyroidectomy due tonodular goiter in Bitlis province; and papillary thyroid carcinoma was the most observedcancer type.

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