Research Article

Risk of neoplasia and malignancy in "dominant" thyroid swellings.

BMJ 1991; 303 doi: (Published 06 July 1991) Cite this as: BMJ 1991;303:20
  1. E L Cusick,
  2. Z H Krukowski,
  3. C A MacIntosh,
  4. N A Matheson
  1. Department of Surgery, University of Aberdeen.


    OBJECTIVE--To determine the risk of neoplasia and malignancy in "dominant" thyroid swellings. DESIGN--Prospective analysis during six years. SETTING--Thyroid clinic serving the Grampian region. PATIENTS--574 consecutive patients presenting with a discrete thyroid swelling, of whom 179 (31%) were classified clinically as having a dominant area of enlargement within a multinodular gland. RESULTS--After clinical and cytological assessment 77 dominant swellings were excised. Of the excised swellings, 45 were non-neoplastic and 32 neoplastic, including 11 malignant lesions. The minimum incidence of neoplasia and malignancy in all 179 dominant swellings was therefore 18% and 6% respectively. CONCLUSION--Dominant thyroid swellings should be regarded with greater clinical suspicion than has been traditional.