MALİGN TİROİD TÜMÖRLERİNİN EPİDEMİYOLOJİK VE HİSTOMORFOLOJİK DEĞERLENDİRMESİ Epidemiological and Histomorphological Evalualtion of the Malignant Thyroid Tumors

OZET Amac: Tiroid papiller karsinomu genellikle genc eriskinlerde gorulen bir tumor olup pik insidansi 3. ve 6. dekadlardadir. Yas artisi prognozu olumsuz etkileyen en onemli faktordur. Bu calismada tiroidin malign tumorlerinin epidemiyolojisini, histomorfolojik ozelliklerini ve 60 yas uzeri tiroidektomili hastalarda papiller tiroid karsinomu gorulme oranini belirlemeyi amacladik Materyal-metod: Ocak 2014-Ocak 2018 arasinda merkezimizde incelenmis tum tiroidektomi materyalleri retrospektif olarak incelendi. Malign tani almis olgular calismaya dahil edildi. Hasta yasi, cinsiyeti, tumor capi, tumor gorulme orani kriterleri esas alinarak epidemiyolojik veriler belirlendi. Tumorlerin histomorfolojik parametreleri incelendi ve 60 yas uzeri hastalarda tiroid papiller karsinom gorulme sikligi saptandi. Bulgular: Toplam 135 adet tiroidektomi operasyonu gecirmis olgunun 92’si (%68) benign, 43’u (%32) malign tani almistir. 39 olguda (%91) tani papiller karsinom ve papiller mikrokarsinom iken 3 olgu (%7) meduller karsinom, 1 olgu (%2) follikuler karsinom tanisini almistir. Olgularin buyuk bir cogunlugunu (n=23; %59) folikuler varyant, 11 tanesini (%28) klasik varyant, 5’ini (%13) onkositik varyant papiller karsinom olusturmaktadir. Toplam 29 adet 60 yas ve uzerindeki hastanin 24’u (%83) kadin, 5’i (%17) erkektir. Hastalarin 22’sinde (%76) tani benign; 7’sinde (%24) ise tani maligndir. Benign tani alan hastalarda en sik gorulen lezyon multinoduler guatr’dir (MNG), (n= 19, %86). Malign tani alan 60 yas ve uzeri hastalarin tumunun tanisi papiller karsinomdur Sonuc: Calismamizda, tiroidektomi operasyonu gecirmis 60 yas ve uzeri malign tani alan hastalar, tum malign tani alan hastalarin %16’sini olusturmaktadir ve hastalarin %100’unde tani papiller karsinom ve papiller mikrokarsinomdur. Calismamizin sonuclari, literaturdeki onceden yapilmis calismalarla uyumludur. Anahtar Sozcu¨kler: Tiroidektomi; Tiroid; Malign; Karsinom; Epidemiyoloji ABSTRACT Aim: Thyroid papillary carcinoma is a tumor which is generally seen in young patients. Its peak incidence is at the 3rd and 6th decades. Increase in age is the most important factor which adversely affects the prognosis. In the present study, we aimed to determine the epidemiological data and the histomorphological charactheristics of the malignant tumors of thyroid and to determine the incidence of thyroid papillary carcinoma in patients over 60 years of age. Materials and method: We retrospectively reevaluated all of the pathology reports of all patients who has underwent thyroidectomy between January 2014 and January 2018 in our center. The cases with malignant diagnosis were included in the study. The epidemiological data were determined including the criteria of patient age, gender, greatest tumor diameter and malignancy rates. The histomorphological parameters of the tumors of the cases with papillary carcinoma were evaluated and the incidence rate of thyroid papillary carcinoma in patients over 60 years of age was determined. Results: The pathology results of 92 of 135 thyroidectomy cases were benign (68%) whereas that of 43 patients (32%) were malignant. The diagnoses of 39 cases were papillary carcinoma and papillary microcarcinoma (91%) whereas 3 cases (7%) had the diagnosis of medullary carcinoma; one case (2%) had the diagnosis of follicular carcinoma. Most of the papillary thyroid carcinoma cases were follicular variant (n=23; 59%) whereas 11 cases (28%) were classical variant and 5 cases were oncocytic variant papillary carcinoma. The number of cases with the age over 60 was 29. Twenty four of them were female (83%) and 5 of them were male (17%). The pathological diagnoses of 22 patients were benign (76%) whereas 7 patients had malignant diagnoses (24%). The most common benign lesion was multinodular goiter (n= 19, 86%). All of the malignant cases had the diagnoses of papillary carcinoma. Conclusion: In our study, patients with age over 60 years, who had thyroidectomy with malignant diagnoses consisted 16% of the overall patients with malignant diagnoses. 100% of the patients with age over 60 years had the diagnoses of papillary carcinoma and microcarcinoma. The results of our study is in consistence with the previous studies in the literature. Keywords: Thyroidectomy; Thyroid; Malign; Carcinoma; Epidemiology