Evolution of differentiated thyroid cancer during pregnancy in a community University Hospital in Buenos Aires, Argentina

Abstract

Objective: To analyze the presentation, follow-up and evolution of differentiated thyroid cancer (DTC) detected during pregnancy. Subjects and methods: Twenty nine women with DTC detected during pregnancy were analyzed. Group I (n = 13) was seen during pregnancy and DTC was diagnosed during gestation; detection of the nodule occurred during pregnancy (first trimester). Group II (n = 16) was seen after delivery; detection of the nodule occurred during pregnancy (second or third trimester). Complete thyroidectomy, ablative dose of radioactive iodine, and treatment with levothyroxine were performed. Follow-up: neck ultrasound; TSH, free T4, thyroglobulin, and anti-thyroglobulin antibodies with and without treatment with levothyroxine; and 131 I whole body scans. Histological diagnosis, lymph node metastases, tumor size and stage, complications from pregnancy, and DTC evolution were evaluated. Results: 100% of the patients had papillary thyroid carcinoma. Lymph node metastases were detected in 13 (44.8%), and invasion of adjacent extrathyroid tissue in 2 patients. Tumor size was larger in Group II: 22.1 ± 10.9 versus 13.9 ± 3.5 mm; p = 0.03. No differences were found in the tumor stages between groups. All patients had full-term pregnancies and healthy newborns. Follow-up: 5.7 ± 4.3 years; one patient had persistent disease. Conclusions: DTC detected during pregnancy had a favorable evolution. Surgery may be postponed to the post-delivery period, unless there are risk factors that justify it during pregnancy. Arq Bras Endocrinol Metab. 2013;57(4):307-11

Maternal and obstetrical outcome in 35 cases of well‐differentiated thyroid carcinoma during pregnancy

“…The percentage of SGA children (3%) was not higher than that of the general population (5%–10%) . These findings are in agreement with previously published articles …”

“…Obstetrical outcomes of pregnant thyroid cancer patients have mainly been described in case reports and small series. Larger cohorts describe either maternal or obstetrical outcome, or do not specify the treatment during pregnancy …”

“…Larger cohorts describe either maternal or obstetrical outcome, or do not specify the treatment during pregnancy. 16,17,[19][20][21][22] Therefore, the aim of this international cohort study was to evaluate treatment and subsequent neonatal and maternal outcome for pregnant patients with primary WDTC.…”

Metastatic Papillary Thyroid Cancer Diagnosed and Treated during Pregnancy

“…The approach to thyroid cancers diagnosed at pregnancy is open to dispute. It can be said that pregnancy generally do not affect the prognosis of PTC; surgery can be postponed to be performed after the pregnancy period in thyroid cancer cases without spread, especially in ones diagnosed in the period after the second half of pregnancy; and complications and hospital costs are higher and duration of hospitalization is longer in surgery performed during pregnancy (4,(6)(7)(8)(9). On the other hand, there are some studies reporting that pregnancy accelerates the spread of PTC with hormonal effects and PTC seen during pregnancy has a worse prognosis (2, 10, 11).…”

Pregnancy in papillary thyroid cancer survivors

“…It has also been reported that differentiated thyroid cancer is more common in women and is the second most common cancer diagnosed during pregnancy and the postpartum period with a prevalence of 14 per 100.000 live births ( 4 , 5 , 6 ). However, there are conflicting results and opinions in the literature related to PTC-pregnancy interaction and optimal timing of surgical and medical intervention ( 7 , 8 , 9 , 10 , 11 , 12 , 13 ).…”