An Analytical Comparison of Papillary Thyroid Carcinoma Patients Manifested with or without Graves' Disease

There is still no clear relationship between the presence of Graves' disease (GD) and the development of papillary thyroid carcinoma. The aim of this study was to compare the clinicopathologic features of patients diagnosed with papillary thyroid carcinoma (PTC) with thyroid nodules and GD and patients with PTC with thyroid nodules but without autoimmune thyroid disease.

The study was designed in a retrospective manner and included a cohort of 239 patients with PTC who underwent total thyroidectomy. Age at diagnosis, disease stage, PTC subtypes, tumor size, radioactive iodine use, nodule ultrasonographic features, and risk of PTC recurrence were compared between patients with and without GD.

Of 239 patients, 99 (41%) had GD, while 140 patients (without autoimmune thyroid disease) had only PTC. The tumor diameter was significantly smaller in the group with PTC + GD (1.45±1.28 cm vs. 1.81±1.34 cm, p<0.05). Significantly lower multifocal involvement rates were observed in the PTC + GD group compared to PTC-only group (p<0.05). The prevalence of the classic papillary thyroid carcinoma subtype was higher in patients without autoimmune thyroid disease (39% vs. 25.7%, p<0.05). Ultrasonographic features of nodules with GD and PTC do not have different characteristics from those of nodules with PTC without GD.

The risk of structural recurrence at the time of diagnosis appears to be similar when PTC is accompanied by GD as compared to PTC alone. Furthermore, the presence of smaller tumor sizes and less multifocality in GD-PTC coexistence may indicate a better prognosis.