etd Ege Tıp Dergisi 1016-9113 2147-6500 Ege Üniversitesi 10.19161/etd.512517 Health Care Administration Sağlık Kurumları Yönetimi Evaluation of thyroid cancer prevalence in patients with graves disease Graves hastalığında tiroid kanser sıklığının değerlendirilmesi https://orcid.org/0000-0002-1161-3369 Yabanoğlu Hakan Başkent Üniversitesi Adana Dr. Turgut Noyan Uygulama ve Araştırma Merkezi, Genel Cerrahi Kliniği https://orcid.org/0000-0001-9880-3570 Arer İlker Murat Başkent Üniversitesi Adana Dr. Turgut Noyan Uygulama ve Araştırma Merkezi, Genel Cerrahi Kliniği https://orcid.org/0000-0003-3636-8109 Koçer Nazım Emrah Başkent Üniversitesi Adana Dr. Turgut Noyan Uygulama ve Araştırma Merkezi, Patoloji Kliniği https://orcid.org/0000-0003-4266-2881 Sakulen Hargura Abdirahman Başkent Üniversitesi Adana Dr. Turgut Noyan Uygulama ve Araştırma Merkezi, Genel Cerrahi Kliniği, https://orcid.org/0000-0001-5225-959X Avcı Tevfik Başkent Üniversitesi Tıp Fakültesi, Genel Cerrahi Anabilim Dalı 06 28 2019 58 2 166 169 04 26 2018 06 05 2018 Copyright © 1962, Ege Tıp Dergisi 1962 Ege Tıp Dergisi

Aim: Although Graves’ disease and thyroid cancer are commonly occurring diseases, simultaneous occurence israre. Hyperthyroidism is believed to be protective against thyroid cancer hence the rare simultaneous occurrence. Inour study we intend to evaluate thyroid cancer prevalence in patients operated for Graves’ disease in our center.Materials and Methods: Files of 210 patients who underwent total thyroidectomy for Graves’ disease between 2009-2018 were retrospectively reviewed. Demographic and clinical features of 38 patients with thyroid cancer diagnosis inthe pathology report were evaluated.Results: In our study 25 (65.8%) of the patients were women, 13 (34.2%) were men and the average age was 40(17-68). In ultrasonographic imaging 20% (43/210) of the patients had thyroid nodules, while 57% (22/38) of patientswith confirmed carcinoma in the pathologic evaluation had thyroid nodules. Functional neck dissection was performedon1 patient secondary to thyroidectomy. 12 of the patient received radioactive iodine treatment. Our average followup period was 30 (3-108) months. During the follow-up 2 (5.2%) patients had recurrence of papillary cancer in thethryoidectomy area at 12th and 18th months. Both patients received RAI treatment. There was no subsequentrecurrence in the follow-up of both the patients.Conclusion: Although simultaneous occurrence of Graves’ disease and thyroid cancer is rare, fine needle aspirationbiopsy should be performed on Graves’ disease patients where ultrasound imaging during follow-up reveals findingsof thyroid nodules. Moreover, surgery should be a priority option as treatment modality in Graves’ diseaseaccompanied by thyroid nodules.

Amaç: Graves hastalığı ve tiroid kanserleri sık görülen hastalıklar olmasına rağmen her iki hastalığın birlikteliği nadirbir durum olarak karşımıza çıkmaktadır. Bu durumun nadir olmasında hipertiroidinin, tiroid kanserine karşı koruyucubir etkisinin olduğunu düşündürmektedir. Çalışmamızda graves hastalığı nedeni ile total tiroidektomi uyguladığımızhastalardaki tiroid kanser sıklığını belirlemeyi amaçladık.Gereç ve Yöntem: 2009-2018 yılları arasında graves hastalığı nedeni ile total tiroidektomi yapılan 210 hastanındosyası geriye dönük olarak incelendi ve patoloji sonucunda tiroid kanseri tanısı alan 38 hasta demografik ve kliniközellikleri açısından değerlendirildi.Bulgular: Hastaların 25’i (%65,8) kadın, 13’ü (%34,2) erkek ve ortalama yaşları 40 (17-68) idi. Ultrasonografikincelemede tüm hastaların (43/210) %20’ de tiroid bezinde nodül varken, patoloji sonucunda karsinom tespit edilenhastaların (22/38) %57’sinde nodül mevcuttu. Tiroidektomi yapılan hastaların patolojik incelemelerinde 38 (%18)hastada tiroid kanseri mevcuttu. Tiroidektomi sonrası 1 hastaya boyun diseksiyonu uygulandı. On iki hastayaradyoaktif iyot tedavisi uygulandı. Ortalama takip süresi 30 (3-108) ay idi. Takiplerde 2 (%5,2) hastada 12. ve 18.aylarda tiroidektomi lojunda papiller kanser nüksü görüldü. Her iki hastaya da RAİ tedavisi uygulandı. Takiplerde nüksizlenmedi.Sonuç: Graves hastalığı ve tiroid kanser birlikteliği nadir olsa da özellikle graves hastalığı nedeni ile takip edilen veyapılan ultrasonografide nodül bulunan hastalarda mutlaka ince iğne aspirasyon biyopsisi yapılmalıdır. Tiroiddokusunda nodül içeren graves hastalarında cerrahi tedavi seçeneği daha ön planda düşünülmelidir.

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