Acromegalia e doença tiroideana: prevalência de câncer de tireóide

Abstract

RESUMOA relação entre câncer e acromegalia tem sido objeto de estudo há muitos anos. A partir de um caso de carcinoma diferenciado de tireóide em um de nossos pacientes acromegálicos, estudamos uma série de 100 outros acromegálicos e encontramos dois outros casos de câncer de tireóide, descritos neste trabalho. A partir daí, levantamos os dados da literatura sobre esta última associação e sua possível patogênese. A prevalência de patologias tireoidianas é aumentada dentre os acromegálicos, às custas, principalmente, do bócio nodular. Esta associação será abordada, assim como a relação entre o fator de crescimento insulina símile I (IGF-I) e câncer, numa tentativa de entender melhor seu significado frente aos nossos casos. Nós concluímos que seria prudente realizar exame ultrassonográfico periódico em acromegálicos, seguido de Punção Aspirativa com Agulha Fina (PAAF) dos nódulos suspeitos. The relationship between cancer and acromegaly has been subject of study for many years. From a case of differentiated thyroid carcinoma in one of our acromegalic patients, we reviewed a series of 100 acromegalics and found two others cases of thyroid cancer, which are described in this work. From that point, we have got data from the literature about this last association and its possible pathogenesis. The prevalence of thyroid disease is increased among acromegalic patients, mainly due to nodular goiter. This association will be discussed, as well as the relation between insulin-like growth factor-I and cancer, in an effort to have a better understanding of its meaning for our cases. We concluded that it would be prudent to do periodic ultrasonografic evaluation of acromegalic patients, follow by fine needle aspiration biopsies of suspect nodules. UM LARGO ESPECTRO DE MANIFESTAÇÕES clínicas sistêmicas caracteriza a acromegalia. Bócio, pólipos colônicos, número aumentado de papilomas cutâneos (skin tags) e hiperidrose são geralmente descritas ao diagnóstico, juntamente com crescimento exagerado das mãos e pés, e características faciais grosseiras.Neoplasias malignas são consideradas, em conjunto com doenças

Thyroid and colorectal cancer screening in acromegaly patients: should it be different from that in the general population?

“…The exception is the report from the Endocrine Society, stating that thyroid ultrasound should be offered to acromegalic patients with a palpable thyroid nodule (29). Other authors also consider it rational to perform periodic ultrasonographic evaluation in acromegaly, followed by fine-needle aspiration biopsies of suspect nodules (96). This is also the proposal of Siegel et al who suggest careful monitoring of goiter and thyroid nodules, including fine-needle aspiration of nodules that are 1 cm or larger in acromegalic patients with persistently elevated IGF-I levels (89).…”

Thyroid Disorders in Saudi Patients With Acromegaly: A Tertiary Care Center Experience

“…By contrast, thyroid cancer is rare. However, some studies show that the prevalence of thyroid cancer is slightly increased compared to the general population and can range from 4.7% to 5.6% of patients, represented mostly by the papillary variant [12][13][14]. The frequency of thyroid autoimmunity in acromegaly is comparable to that of the general population [6].…”