Thyroid calcification: radiographic patterns and histological significance

Abstract

Aim. To determine the incidence, significance and plain radiographic patterns in goiters with calcification. Materials and Methods. Radiographs (chests, thoracic inlets and neck) and clinical records of 160 goiterous patients were reviewed retrospectively, and classified into two groups; those with calcification and those without calcification. Data analysis was by SPSS 11.0. Results. The majority of our patients (64.9 %) were in their 4th to 6th decade of life with modal age of 30 years. The ratio of males to females was 3: 17. Radiographic calcification was demonstrable in 17.0% (male 22.2% and female 77.8%) and this increased steadily by about three–fold per decade of life from 3rd–5th decade. All patients with calcification had tracheal narrowing, higher occurrence of cervical degeneration and 3–fold incidence of retrosternal extension of goitres. However, only four out of thirteen patients (14.8%) with malignant histology had calcification, while the remaining nine patients had no calcification. Subtotal thyroidectomy was offered in 89.3% of patients with calcification. Conclusion. Calcification of goitre increases steadily with advancing age and is more common in multinodular than solitary thyroid nodules. However, it does not suggest benignity or malignancy of the thyroid mass. There is high propensity of calcification in goitres having retrosternal extension and a strong tendency for concentric tracheal narrowing in calcified goitres. Hence, this may make the need for early thyroidectomy imperative.