Papillary Thyroid Cancer: A Histopathological Review in Accra, Ghana

There is paucity of information on papillary thyroid cancer (PTC) in Ghana. The aim of this study was to determine the relative proportions of thyroid malignancies diagnosed in our institution that were PTC, the trend and the clinico-pathological characteristics.

Materials and Methods: A review of all thyroid malignancies diagnosed in our department from January 1994 to December 2013 was conducted. Data was entered and analysed using SPSS software (Version 23 Chicago).

Results: Papillary thyroid cancer was the commonest thyroid malignancy (52.7%). There was a gradual decline in the numbers of cases during the period under review. Approximately 60.3% of the patients were younger than 40 years. The great majority (77.6%) were females with a female to male ratio of 4:1. Four patients (4) presented with symptoms of metastatic disease (headache in 2; pathological fracture of the femur in 1; and dysphagia - 1). Many of the patients (62.9%) presented after 2 years with large anterior neck swelling. PTC was commonly diagnosed in total thyroidectomy specimens (43.1%). Follicular variant of PTC was the commonest histological subtype (75.6%). Lymphovascular invasion was found in approximately 16.4% of the cases. Nine of the cases (7.8%) showed extra-glandular involvement.

Conclusion: The study found papillary thyroid cancer to be the commonest thyroid malignancy. There was a gradual decline in the number of cases over the period of study. Many of the patients were younger than 40 years of age and presented late with large palpable neck swellings. Approximately, 4.3% of patients presented cases with metastatic disease.