A Five Year Study Of Primary Carcinoma Of The Thyroid Gland At Kenyatta National Hospital 1976-1980

Abstract

Compared to other thyroid diseases, primary thyroid tumours are rare. Benign thyroid swellings are quite common especially in endemic gotre areas. As such the disease may be missed due to lack of awareness that a thyroid swelling may be malignant. Long standing and rapidly growing thyroid swelling should receive special attention especially in patients around fourty-five years of age. Waiting for other·presenting symptoms may be too late. A series of 43 patients with primary carcinoma of thyroid gland were seen in Kenyatta National Hospital between January 1976 and December 1980. Of these, 33 were females and 10 were males. The youngest patient was fourteen years old while the oldest patients seen were over Seventy years. The average age was 48 years. Most patients presented late for management. Ignorance on the part of the natient" and the slow referral system contributed to the delay in diagnosis of the disease. Patients do take matters of health for granted or as "fate of God". The referral system is long and may cause the patient to give up or to come very late when nothing can be done. There is therefore need for awareness of the disease among the medical personnels in the peripheral medical care units. Health education should also emphasise the importance of early medical consultations. Surgery and radiotherapy were found to be the standard treatment for the disease. This is only possible at Kenyatta National Hospital due to presence of radiotherapy Unjt and qualified thyroid surgeons. This puts a check on the peripheral management of the disease. About two thirds of the natients were lost or dead. This resulted in a follow-up of about a third of the patients. These were mostly patients with papillary and some follicular carcinomas. The mortality was thus about three deaths per year.