Prevalence of Thyroid Cancer in Lebanon: What is the Role of Fine Needle Aspiration Biopsy?Pages 1-9

Khadija Jamal Saad1,2, Mirvat Mohammad Ballout3, Zahraa El Najjar4, George Phillip Aftimos5, Elie Mekhael Gharios1,6 and Marie Tanios Merheb1,6

1Department of Endocrinology, Mount Lebanon Hospital, Beirut, Lebanon; 2Endocrinology Fellow, Lebanese University, Hadath, Lebanon; 3Department of Chemistry and Biochemistry, Lebanese University, Hadath campus, Lebanon; 4Anathomo-Pathology Resident, Lebanese University, Hadath, Lebanon; 5Anathomo-Pathologist, National Institute of Pathology, Lebanon; 6Clinical Endocrinology, Mount Lebanon Hospital, Beirut, Lebanon


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Abstract: Objective: This study aims to report the prevalence of thyroid cancer in Lebanon and the role of fine needle aspiration biopsy in the diagnosis of thyroid cancer.

Methods: It is a retrospective study in which 928 patients were included. The thyroid pathology samples were obtained either by thyroidectomy or fine needle aspiration biopsy. They were collected between 2006 and 2016 from the different centre and hospitals in Lebanon by the National Institute of Pathology and then analyzed in this institute.

Results: Incidence of thyroid cancer was 61 % (574 patients) with 90.51 % (519 patients) diagnosed by thyroidectomy, and 9.58 % (55 patients) diagnosed by FNA. 91.45 % of patients (525 patients) had papillary carcinoma, 5.58 % of patients (32 patients) had follicular carcinoma, 2.27 % of patients (13 patients) had anaplastic carcinoma, 0.17 % (1 patient) had medullary carcinoma, 0.17 % (1 patient) had large B cell lymphoma, 0.17 % (1 patient) had mucosa-associated lymphoid tissue lymphoma (MALT), 0.17 % (1 patient) had concomitant papillary and medullary carcinoma. Male to female ratio was 1:5, the median age at diagnosis was 45 years, the median size of the maximal tumour was less than 1 cm, and the most common involved lobe was the right thyroid lobe. 7.6 % (71 patients) had metastasis, with regional lymph node metastasis being the most common (74.65 %; 53 patients).

Conclusion: Papillary carcinoma is the most common thyroid cancer in the studied population. Females are significantly more concerned with thyroid cancer than males. The fine needle aspiration biopsy may be overused, and most of the suspicious nodules on ultrasonography tend to be benign on pathology result.

Keywords: Thyroid cancer, Lebanon, pathology, fine needle aspiration biopsy. Read more