barw Judi Clinical Journal 3105-4102 1 2 2025 11 12 Preoperative Thyroglobulin and Thyroid Pathologies: A Single Center Experience 71 75 10.70955/JCJ.2025.9 eng Shaho F. Ahmed Endocrine Department, Shar Hospital, Malik Mahmud Ring Road, Sulaymaniyah, Iraq. Rebaz M. Ali Oncology Department, Hiwa Cancer Hospi tal, Shorsh Street, Sulaymaniyah, Iraq Rawa M. Ali Department of Pathology, Hospital for Treatment of Victims of Chemical Weapons, Mawlawy Street, Halabja, Iraq Ari M. Abdullah Department of Pathology, Sulaymaniyah Teaching Hospital, Zanko Street, Sulaymaniyah, Iraq Abdulwahid M. Salih Scientific Affairs Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq Hiwa O. Baba Scientific Affairs Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq Rebaz O. Mohammed Scientific Affairs Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq Aso N. Qadir Scientific Affairs Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq Shko H. Hassan Zad Organization, Saeed Kaban Street, Judi tower, Sulaymaniyah, Iraq Abdullah A. Qadir Scientific Affairs Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq Harun A. Ahmed Scientific Affairs Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq Hawkar A. Nasralla Scientific Affairs Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq Berun A. Abdalla Scientific Affairs Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq Fahmi H. Kakamad College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaymaniyah, Iraq 0000-0002-2124-9580 2025 08 26 Introduction: Thyroid nodules are frequently found in the general population, though malignancy is confirmed in only a minority of cases. Distinguishing between benign and malignant nodules before surgery is vital for appropriate clinical management. The utility of preoperative serum thyroglobulin (Tg) levels as a diagnostic marker in thyroid carcinomas remains controversial. This study aimed to provide a descriptive overview of patients with markedly elevated preoperative Tg levels (>500 ng/mL) and their corresponding histopathological outcomes. Methods: A retrospective, single-center study was conducted at Smart Health Tower, which included patients who underwent surgical interventions for thyroid disorders between 2019 and 2025, with preoperative serum Tg levels exceeding 500 ng/mL. Patients were excluded if they had incomplete medical records. Patient demographics, clinical features, preoperative findings, surgical details, and final histopathology were retrieved from electronic medical records. Results: A total of 260 patients were included, predominantly female (73.08%), with a median age of 49 years (QR: 38–61). Neck swelling was the most common symptom (63.08%). Ultrasonography showed follicular nodular disease in 60.0%. Fine-needle aspiration cytology revealed Bethesda II in 20.0%, IV in 13.85%, and VI in 11.15% of cases. Total thyroidectomy was performed in 74.62% of cases. Histopathology showed benign lesions in 70.77% and malignant lesions in 29.23% of the cases. Conclusion: Preoperative Tg levels may be elevated in both benign and malignant thyroid disorders; however, Tg may not possess adequate diagnostic precision to be used as a sole indicator of malignancy.