Thyroid carcinoma at King Edward VIII Hospital, Durban, South Africa.

Background: Western literature depicts papillary carcinoma as the most common thyroid malignancy followed by follicular carcinoma.

Objective: To assess the clinical pattern of thyroid carcinoma among African and Indian patients.

Setting: King Edward VIII Hospital, Durban, South Africa.

Design: A retrospective study.

Subjects: One hundred patients with thyroid carcinoma treated at a tertiary teaching hospital between 1990 and 1997.

Results: Seventy seven patients were Africans and 23 were Indians. The male to female ratio was 1:6. Ninety eight patients presented with goitre with or without regional lymph node involvement or distant disease. The duration of symptoms ranged from one to 360 months. The mean age at presentation was 48.6 +/- 16.0 years. Follicular carcinoma was the most common malignancy among African patients (68%), followed by papillary carcinoma (16%), anaplastic carcinoma (13%) and medullary carcinoma (2.6%). Papillary carcinoma was the most common malignancy among Indian patients (57%) followed by follicular carcinoma and medullary carcinoma. There was no anaplastic carcinoma among Indian patients. Fifty five patients underwent lobectomy with 32 undergoing subsequent completion thyroidectomy. Nine patients had near total thyroidectomy, 27 were offered total thyroidectomy as primary surgery and eight had biopsy only. The in-hospital mortality was 8%. Recurrence rate was 8%.

Conclusion: Most patients present long after the development of symptoms. Follicular carcinoma is the most common thyroid malignancy among Africans. Further studies are required to explain this phenomenon.