Thyroid Cancer in Solid-Organ Transplant Recipients

One of the best treatment methods for end-stage organ failure is solid-organ transplant. Experiences gained in the postoperative treatment and follow-up of transplant recipients continue to guide the morbidity and mortality rates of patients. Evaluations regarding the increased risk of thyroid cancer after solid-organ transplant are still controversial. In this study, we aimed to examine the incidence of thyroid cancer development in solid-organ transplants cross-sectionally.

We conducted a retrospective cross-sectional study at a single center, which included 23 patients who had undergone liver and kidney transplant and were diagnosed with thyroid cancer after transplant. Among the included patients, 21 had undergone kidney transplant and 2 had undergone liver transplant. The patients' thyroid cancer types, postoperative thyroglobulin and anti-thyroglobulin levels, and whether they received radioactive iodine therapy after surgery were examined. We also investigated whether the deceased patients died primarily from thyroid cancer.

Among 1191 transplants were performed at our clinic, 851 were kidney transplants and 340 were liver transplants. Thyroid malignancy was detected in 23 (1.93%) of these cases. The mean age was 54.48 ± 11.41 years, ranging from 38 to 76 years. Fine needle aspiration biopsy results showed suspicious findings for malignancy in 1 case (4.35%), atypia of uncertain significance in 1 case (4.35%), and findings consistent with papillary carcinoma in 21 cases (91.30%). Seventeen patients (73.91%) had papillary carcinoma, whereas others had papillary microcarcinoma. Four patients (17.39%) in the study died, and retrospective review of the records for the primary causes of death showed that all were from causes unrelated to the thyroid.

This study showed that the incidence of thyroid cancer has increased in solid-organ transplants, but mortality rates from thyroid cancer have not been affected.