Coexistence of hyperthyroidism and thyroid cancer

Year 2014, Volume: 41 Issue: 2, 364 - 367, 01.06.2014

Fatih Taşkesen Ömer Uslukaya Hekim Kuzu Metehan Gümüş Sadullah Girgin Bilsel Baç

https://doi.org/10.5798/diclemedj.0921.2014.02.0432

Abstract

Objective: Thyroid cancer can be associated with thyrotoxicosis caused by Graves' disease, toxic multinodular goiter, or toxic nodular goiter. The aim of this study was considered to be endemic in our region have received the diagnosis of hyperthyroidism, thyroid cancer is detected thyroidectomy performed and patients were retrospectively evaluate. Methods: We retrospectively studied 69 patients assessed for hyperthyroidism between 2006 and 2012. Clinical hyperthyroidism was diagnosed by elevated tri-iodothyronine/thyroxine (T3/T4) ratios and low thyroid-stimulating hormone (TSH) levels, with clinical signs and symptoms. The criteria for surgery were cytological evidence of malignancy, a goiter causing symptoms of tracheal or esophageal compression, side effects of antithyroid drug therapy, or Graves\' disease with multiple relapses after therapy withdrawal or responsiveness to antithyroid drugs. Results: Totally 69 patients were included. In 20 (28.9%) patients there was toxic multinodular goiter, in 28 (40.6%) Graves\'s disease, and in 21 (30.5%) patients there was toxic nodular goiter. Of these patients, 12 (17.4%) had thyroid cancer. Conclusions: As a result; low likelihood of malignancy in patients with hyperthyroidism, though suspicious lesions detected in the lymph nodes and neck adenopathies be examined in detail.

Keywords

Hyperthyroidism, thyroid cancer, thyroid malignancy

Hipertiroidizm ile tiroid kanseri birlikteliği

Abstract

Amaç: Tiroid kanseri hipertiroidizmin nedeni olabilen Graves hastalığı, toksik multinodüler guatr veya toksik nodüler guatr ile ilişkili olabilir. Bu çalışmanın amacı endemik guatır bölgesi olarak kabul edilen bölgemizde hipertiroidi tanısı almış, tiroidektomi yapılmış ve tiroid kanseri tespit edilen hastaları retrospektif olarak değerlendirmektir. Yöntemler: 2006 ve 2012 yılları arasında hipertiroidili 69 hasta retrospektif olarak incelendi. Klinik hipertiroidizm Triiyodotironin/Tiroksin (T3/T4) seviyelerinin yüksekliği ve TSH düzeyinin düşüklüğü, klinik bulgular ve semptomlar ile tanı konuldu. Cerrahi operasyon için kriterler; malignitenin sitolojik olarak kanıtlanması, guatırın özafagusa veya trakeaya bası semptomlarına neden olması, antitiroid ilaç tedavisinin yan etkileri veya antitiroid ilaçlara cevapsızlıktı. Bulgular: Hastaların 20 (%28,9)\'de toksik multinodüler guatr, 28 (%40,6)\'de Graves hastalığı, 21 (%30,5)\'de toksik nodüler guatr tanısı almış 69 hasta vardı. Bu hastalardan 12 (%17,4)\'de tiroid kanseri tespit edildi. Sonuç: Hipertiroidili hastalarda malignite ihtimali düşük olsa da şüpheli lezyonlar, nodüller ve boyunda saptanan lenf adenopatiler ayrıntılı olarak incelenmelidir.

Keywords

Hipertiroidizm, tiroid kanseri, tiroid malignitesi

References

• Franceschi S, La Vecchia C. Thyroid cancer. Cancer Surv 1994;19-20:393-422.
• da hipertiroidili hastalarda tiroid kanser oranı %5,8
• Saklamaz A, Sivrikoz O, Çökmez A. Graves hastalığında rastlantısal saptanan papiller karsinom: Olgu sunumu. Türk Jem 2012;16:102-104.
• Olen E, Klinck GH. Hyperthyroidism and thyroid cancer. Arch Pathol 1966;81:531-535.
• Dobyns BM, Sheline GE, Workman JB, et al. Malignant and benign neoplasms of thyroid in patients treated for hy- perthyroidism: a case report of the Cooperative Thyrotok- sikosis Therapy Follow-up Study. J Clin Endocrinol Metab 1974;38:976-980.
• Zanella E, Rulli F, Muzi M, et al. Prevalance of thyroid can- cer in hyperthyroid patients treated by surgery. World J Sur- gery 1998;22:473-478.
• Rieger R, Pimpl W, Money S, et al. Hyperthyroidism and concurrent thyroid malignancies. Surgery 1989;106:6-10.
• Cappelli C1, Braga M, De Martino E, et al. Outcome of pa- tients surgically treated for various forms of hyperthyroid- ism with differentiated thyroid cancer: experience at an en- docrine center in Italy. Surg Today 2006;36:125-130.
• Cantalamessa L, Baldini M, Orsatti A, et al. Thyroid nodules in Graves’ disease and the risk of thyroid carcinoma. Arch Intern Med 1999;159:1705–1708.
• Farbota L, Calandra D, Lawrence A, Paloyan R. Thyroid carcinoma in Graves’ disease. Surgery 1985;98:1148–1152.
• Kasuga Y, Sugenoya A, Kobayashi S, et al. The outcome of patients with thyroid carcinoma and Graves’ disease. Surg Today 1993;23:9–12.
• Augusti T, Codegone A, Pallerito R, Favero A. Thyroid can- cer prevalence after radioiodine treatment of hyperthyroid- ism. J Nucl Med 2000;41:1006–1009.
• Lividas D, Psarras A, Koutras D. Malignant cold thyroid nodules in hyperthyroidism. Br J Surg 1976;63:726–728.
• Pazaitou-Panayiotou K, Michalakis K, Paschke R. Thyroid cancer in patients with hyperthyroidism. Horm Metab Res 2012;44:255-262.
• Pazaitou-Panayiotou K, Perros P, Boudina M, et al. Mortal- ity from thyroid cancer in patients with hyperthyroidism: the Theagenion Cancer Hospital experience. Eur J Endocri- nol 2008;159:799–803.
• Hayes F J, Sheaham K, Heff ernan A, McKenna T J. Ag- gressive thyroid cancer associated with toxic nodular goi- tre. Eur J Endocrinol 1996;134:366–370.
• Habra M A, Hijazi R, Verstovsek G, Marcell M. Medullary thyroid carcinoma associated with hyperthyroidism: a case report and review of the literature. Thyroid 2004;14:391– 396.
• Alagöl F, Tanakol R, Boztepe H, et al. Anaplastic thyroid cancer with transient thyrotoxicosis: case report and litera- ture review. Thyroid 1999;9:1029–1032.
• Senyurek Giles Y, Tunka F, Boztepe H, et al. The risk fac- tors for malignancy in surgically treated patients for Graves’ disease, toxic multinodular goiter, and toxic adenoma. Sur- gery 2008;144:1028–1037.
• Cakir M, Arici C, Alakus H, et al. Incidental thyroid carci- noma in thyrotoxic patients treated by surgery. Horm Res 2007;67:96 – 99.
• Mazzaferi EL. Thyroid cancer and Graves’ disease. J Clin Endocrinol Metabl 1990;70:826-829.
• Terzioğlu T, Tezelman S, Onaran Y, Tanakol R. Concur- rent hyperthyroidism and thyroid carcinoma. Br J Surg 1993;80:1301-1302.
• Collins SL. Thyroid cancer: controversies and etiopatho- genesis. Falk SE. Thyroid Disease: Second Edition. Lip- pincott Raven. Philadelphia 1997;495-564.
• Zanella E, Rulli F, Muzi M, et al. Prevalence of thyroid cancer in hyperthyroid patients treated by surgery. World J Surg 1998;22:473-478.
• Harach HR, Escalante D, Onativa A, et al. Thyroid carci- noma and thyroiditis in an endemic goiter region before and after iodine prophylaxis. Acta Endocrinol 1985;108:55-59.
• Hancock BW, Bing RF, Dirmikis SM, et al. Thyroid carcino- ma and concurrent hyperthyroidism. Cancer 1977;39:298- 302.