Incidental thyroid carcinoma in a population with goiter: A retrospective cohort study.

Abstract

Introduction: Incidental thyroid carcinoma is the unexpected discovery of malignancy in patients undergoing thyroid surgery initially intended for preoperatively considered benign diseases. Objective: This study aims to describe a cohort of patients with Incidental thyroid carcinoma and identify the primary risk factors for malignancy. Methods: A retrospective cohort study was conducted on patients with goiter and Bethesda II cytology nodules who underwent thyroidectomy over a four-year period. The analysis included descriptive statistics, bivariate, and multivariate analyses, with Incidental thyroid carcinoma as the primary outcome. Results: Among the 299 patients meeting the inclusion criteria, multinodular goiter affected 49.49% of patients. Incidental thyroid carcinoma was diagnosed in 38 patients (12.7%). Papillary carcinoma was the most frequent malignant histology, comprising 83.7% of cases, with the classic variant being the most common (43.2%). In both bivariate and multivariate statistical analyses, multinodular goiter was identified as an independent risk factor for presenting malignant thyroid pathology (OR, 2.461; 95% CI, 1.654-3.659; p = 0.023). Conclusion: Incidental thyroid carcinoma is not an uncommon occurrence, and multinodular goiter has been established as an independent risk factor. Micropapillary thyroid carcinomas were the most prevalent among patients presented with incidental thyroid carcinoma.