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Thyroid cancer in patients with toxic nodular goiter--is the incidence increasing?
Kevin C Choong1, Christopher R McHenry1
1Department of Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA.
Background:
There has been a dramatic increase in the incidence of thyroid cancer, but it is unclear if this has occurred in patients with toxic nodular goiter (TNG).
Methods:
TNG was defined as one or more thyroid nodules in combination with a low serum TSH level. Patients who underwent thyroidectomy for TNG were identified from a prospectively maintained database. The rates of incidental thyroid cancer were compared over the intervals 1990 to 1999, 2000 to 2009, and 2010 to 2014.
Results:
There was no significant difference in cancer rate between the 3 time periods. Overall, 7 (4.7%) of the 148 patients had thyroid cancer; similarly, 1 (3.2%) of the 31 patients from 1990 to 1999, 3 (4.2%) of 72 patients from 2000 to 2009, and 3 (6.7%) of the 45 patients from 2010 to 2014 (P > .05) had thyroid cancer.
Conclusions:
No significant increase in the rate of carcinoma was observed in patients with TNG. As a result, the risk benefit analysis should not change when considering therapeutic options for TNG.
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