Thyroid calcification: radiographic patterns and histological significance

Abstract

Background. Calcification of the thyroid gland may occur inboth benign and malignant thyroid diseases. Aim. To determinethe incidence, significance and plain radiographic patternsin goiters with calcification. Materials and Methods.Radiographs (chests, thoracic inlets and neck) and clinicalrecords of 160 goiterous patients were reviewed retrospectively,and classified into two groups; those with calcificationand those without calcification. Data analysis was by SPSS11.0. Results. The majority of our patients (64.9 %) were intheir 4th to 6th decade of life with modal age of 30 years. Theratio of males to females was 3: 17. Radiographic calcificationwas demonstrable in 17.0% (male 22.2% and female 77.8%)and this increased steadily by about three–fold per decadeof life from 3rd–5th decade. All patients with calcification hadtracheal narrowing, higher occurrence of cervical degenerationand 3–fold incidence of retrosternal extension of goitres.However, only four out of thirteen patients (14.8%) with malignanthistology had calcification, while the remaining ninepatients had no calcification. Subtotal thyroidectomy was offeredin 89.3% of patients with calcification. Conclusion. Calcificationof goitre increases steadily with advancing age andis more common in multinodular than solitary thyroid nodules.However, it does not suggest benignity or malignancy ofthe thyroid mass. There is high propensity of calcification ingoitres having retrosternal extension and a strong tendencyfor concentric tracheal narrowing in calcified goitres. Hence,this may make the need for early thyroidectomy imperative.