Outcome of incidental thyroid carcinoma in patients undergoing surgery for Graves' disease

Thyroid malignancy detected incidentally in patients who are operated for Graves'disease (GD) has been reported at different rates. The aim of this study was to investigate the rate and outcome of incidental thyroid carcinoma in thyrotoxic GD patients managed by surgery in our institution.

A retrospective study was performed on a consecutive series of 92 patients with GD operated between January 2000 and December 2006 in the Department of Surgery of the Philipps University, Marburg. All patients were identified via the central electronic patient registry. Incidence and outcome of thyroid carcinoma incidentally discovered in patients undergoing surgery for GD were analysed.

82.6% were females and 17.4 were males. Mean age at time of surgery was 41.6 years (range: 12-72). Mean hospital stay was 5 days (range: 1-21). Two (2.2%) of all patients had a papillary thyroid microcarcinoma. Tumour size was 3 mm and 5 mm. Multifocality and lymph node involvement were not detected. Following thyroidectomy, the two patients are well and disease free with a follow-up of 6, respectively 3 years.

The incidence of incidentally thyroid microcarcinoma was not higher in patients with GD compared to other benign thyroid disorders described in the literature. Differentiated thyroid cancer found incidentally at surgery for hyperthyroidism seems to have a good prognosis.