Hyperthyroidism and Concurrent Thyroid Cancer

R, Vaiana; Cappelli, Carlo; Perini, Paola; Pinelli, D.; G, Camoni; Farfaglia, Roberto; Balzano, Rino; Braga, Marco

doi:10.1177/030089169908500407

Cited by 35 publications

(24 citation statements)

References 21 publications

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“…In our series the incidence of hyperthyroidism in TC patients is 2.8% and the incidence of TC in active nodules is 1.2%. The data in the literature mostly report cases of TC associated with hyperthyroidism in patients with Graves' disease and these patients were reported to have more frequent TC incidence than patients with hyperfunctioning autonomous thyroid nodules [16]. None of our patients had Graves' disease and so the incidence of ToxTC in our series is quite high.…”

Section: Discussionmentioning

confidence: 59%

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The incidence of hyperthyroidism in patients with thyroid cancer in an area of iodine deficiency

Gülçelik¹,

Gülçelik

Dinç³

et al. 2006

J. Surg. Oncol.

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Section: Discussionmentioning

confidence: 59%

“…Als et al [13] reported 19 ToxTC patients in a series of 845 DTC patients found follicular carcinoma more frequent (15/19). Gabriele et al and Vaiana et al [15,16] reported papillary carcinoma more frequent in their series of ToxTC. In our ToxTC patients papillary carcinoma was predominant as was in studies of Vaiana et al and Gabriele et al…”

Section: Discussionmentioning

confidence: 87%

The incidence of hyperthyroidism in patients with thyroid cancer in an area of iodine deficiency

Gülçelik¹,

Gülçelik

Dinç³

et al. 2006

J. Surg. Oncol.

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“…We concluded that patients' age at the time of diagnosis couldn't predict the final outcome, but the mean age in our study was less than in previous studies (39.3 ± 13.0 years). It could be a consequence of an earlier diagnosis, probably due to our particularly attention to thyrotoxicosis as previously demonstrated [37,38].…”

Section: Discussionmentioning

confidence: 80%

Prognostic Value of Thyrotropin Receptor Antibodies (TRAb) in Graves' Disease: A 120 Months Prospective Study

et al. 2007

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Abstract. In most trials, at least 30-60% of patients with Graves' disease treated with antithyroid drugs relapse within 2 years after therapy withdrawal. At present, there are no prognostic parameters available early in treatment to indicate patients likely to achieve long-term remission. Because thyrotropin receptor autoantibodies (TRAb) are specific for Graves' disease, we evaluated the ability of their levels and of their rate of change to predict long-term prognosis. In our study 216 consecutive patients with newly diagnosed Graves' disease started a therapy with methimazole. Patients were treated until they achieved euthyroidism and TRAb were measured at 6-month intervals throughout a follow up of 120 months. Our study demonstrated that at the onset of hyperthyroidism patients' age, sex, fT4 levels and goiter size had no prognostic value in predicting long-term prognosis (respectively p = 0.79; p = 0.98; p = 0.83; p = 0.89). On the contrary, at the time of diagnosis TRAb titer was a good predictor of the final outcome (p<0.001); a titer equal to (or) more than 46.5 UI/L could identify patients who had never achieved long-term remission with a sensitivity of 52% and a specificity of 78%. Also fall rate of TRAb at 6 months of follow up and after therapy withdrawal were useful to predict the final outcome (p<0.001). At 6 months of follow up the time of therapy withdrawal, a decrease of TRAb lower than 52.3% or even its increase could identify patients who had never achieved permanent remission with a sensitivity of 55% and a specificity of 79.1%. No single parameter among TRAb, satisfactory identified a sub-set of patients who achieved long remission. Accordingly to our data, the best result in predicting long term remission is probably given by the presence of at least one of the two features evaluated at 6 months (TRAb titer and/or percentage of TRAb fall rate), with a sensitivity of 63% and specificity of 88%. TRAb titers evaluated both at the onset of hyperthyroidism that at 6 months of therapy or their rate of fall at 6 months and at ATD withdrawal are predictors of outcome. However, the presence of at least one, between titers of TRAb or their rate of fall at six months, resulted to be the best predictor of remission with the higher sensitivity and specificity.

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“…Incidence in thyrotoxicosis has been reported at different rates from different countries or different centers from the same country [1,2,3,4,5,6] (table 2). This difference may be elucidated with patient populations from different geographical areas and iodine intake, exposure to ionizing radiation, the type of surgery, changing selection criteria for surgery and definition of pathological diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…Thyroid carcinoma causing thyrotoxicosis or arising from hyperfunctioning nodules, which is reported to be quite rare, and thyroid carcinoma detected incidentally in patients who are operated for thyrotoxicosis. The incidence for the latter condition has been reported at different rates changing between 0.21 and 16.6% by several authors [1,2,3,4,5,6]. Treatment of choice for thyrotoxicosis in some countries is radioactive iodine (RAI) for both cost-effectiveness and concerns about morbidity and mortality related to surgery.…”

Section: Introductionmentioning

confidence: 99%

Incidental Thyroid Carcinoma in Thyrotoxic Patients Treated by Surgery

Çakır¹,

Arıcı

Alakuş

et al. 2006

Horm Res Paediatr

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Background and Aims: Thyroid malignancy detected incidentally in patients who are operated for thyrotoxicosis has been reported at different rates. The aim of this study was to investigate the rate of incidental thyroid carcinoma in thyrotoxic patients managed with surgery in our institution. Methods: Of the 375 thyrotoxic patients who had thyroid surgery between the years of 1997–2004, 70.7% were females and 29.3% were males. Among thyrotoxic patients 65.3% (n = 245) had toxic multinodular goiter (TMG), 16.8% (n = 63) had toxic adenoma (TA) and 17.9% (n = 67) had Graves’ disease. Results: Twenty-six (6.9%) of all thyrotoxic patients had thyroid carcinoma. Eighteen (7.3%) of TMG, 4 (6.3%) of TA and 4 (6%) of Graves’ disease patients had thyroid carcinoma. Histologic examination revealed 18 papillary (9 microscopic), 5 follicular, 2 hurthle cell and 1 anaplastic carcinoma. Conclusion: In our study, incidental thyroid carcinoma was found in 6.9% of subjects with thyrotoxicosis. Papillary thyroid microcarcinomas constituted 34.6% (26/9) of these newly diagnosed thyroid carcinomas. The incidence of thyroid carcinoma was not higher in subjects with Graves’ disease compared to TMG and TA. The rate of incidental thyroid carcinoma in subjects with thyrotoxicosis treated with surgery was similar to previous studies reported from different countries.

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Hyperthyroidism and Concurrent Thyroid Cancer

Cited by 35 publications

References 21 publications

The incidence of hyperthyroidism in patients with thyroid cancer in an area of iodine deficiency

The incidence of hyperthyroidism in patients with thyroid cancer in an area of iodine deficiency

Prognostic Value of Thyrotropin Receptor Antibodies (TRAb) in Graves' Disease: A 120 Months Prospective Study

Incidental Thyroid Carcinoma in Thyrotoxic Patients Treated by Surgery

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