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Hyperthyroidism with concurrent thyroid cancer.

E Zanella1, F Rulli, M Sianesi

  • 1Department of Surgery, University of Rome Tor Vergata, Italy.

Annali Italiani Di Chirurgia
|January 5, 2002
PubMed
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Thyroid cancer is rare in hyperthyroid patients, but careful evaluation is crucial, especially for toxic adenomas. Occult thyroid cancers, often with unfavorable features, require attention in hyperthyroid individuals undergoing surgery.

Area of Science:

  • Endocrinology
  • Oncology
  • Surgical Pathology

Background:

  • Thyroid malignancy is infrequently associated with hyperthyroidism.
  • Assessing the clinical significance of this association is important for patient management.

Purpose of the Study:

  • To evaluate the incidence of thyroid cancer in hyperthyroid patients undergoing thyroidectomy.
  • To determine the specific types and characteristics of thyroid cancers found in this cohort.

Main Methods:

  • Retrospective analysis of 202 hyperthyroid patients who underwent thyroidectomy over a 20-year period.
  • Histological examination of thyroidectomy specimens to diagnose and classify thyroid cancer.

Main Results:

  • Thyroid cancer was diagnosed in 5.9% (12/202) of hyperthyroid patients.

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  • Papillary carcinoma was most common (9 cases), followed by Hürthle cell (2) and follicular (1) carcinoma.
  • Cancer association was highest in toxic adenomas (17.8%) compared to toxic diffuse goiter (5.3%) and multinodular goiter (1.7%).
  • 8 cancers were occult ( < 1 cm), with 5 showing unfavorable features like invasiveness and multifocality.
  • All 12 patients had favorable outcomes with no evidence of disease post-follow-up.

    • Conclusions:

    • Hyperthyroid patients, particularly those with toxic adenomas, require thorough evaluation for concurrent thyroid malignancy.
    • Particular attention should be paid to occult thyroid lesions, which in this study frequently presented with unfavorable histological characteristics.