Predictive Factors of Thyroid Cancer in Patients with Graves’ Disease

Ren, Meng; Wu, Mu Chao; Shang, Chang Zhen; Wang, Xiao Yi; Zhang, Jing Lu; Cheng, Hua; Xu, Ming; Yan, Li

doi:10.1007/s00268-013-2287-z

Cited by 33 publications

(18 citation statements)

References 39 publications

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“…In the same study, thyroid cancer was not detected in any of the 64 patients with GD [14]. Our results are similar to rates reported by Boutzios et al and Wei et al, which were 33.7% and 32% respectively, but higher than the rates reported by Ren et al (13.7%) and Tam et al (8%) [17,18]. Wei et al also reported a 69% rate of thyroid cancer in patients with nodular GD.…”

Section: Discussionsupporting

confidence: 89%

Frequency of thyroid nodules and thyroid cancer in thyroidectomized patients with Graves’ disease

Çağlar¹,

Şahi̇n²,

Hasanov³

et al. 2020

aoms

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Introduction: Incidental thyroid cancers are frequently detected in patients operated on for Graves' disease (GD). There are no clear data about the incidence and risk factors of incidental thyroid cancer in operated GD patients. The aim of this study is to evaluate the risk of thyroid carcinoma in surgically treated GD patients. Material and methods: The data of 121 GD patients who underwent total thyroidectomy in a single center between 2005 and 2015 were retrospectively evaluated. The diagnosis of thyroid cancer was based on pathological examination. Results: Thyroid cancer was demonstrated in postoperative pathology specimens of 34 patients who were surgically treated for GD (28.1%). Preoperative thyroid ultrasonography (USG) revealed a nodular goiter in 62 (51.2%) patients. Nodules were not detected in the other 59 (48.8%) patients with GD. The frequency of thyroid cancer was significantly higher in patients with nodules (38% vs. 16%; p = 0.009). Thirty-two of the 34 cancer cases had papillary thyroid cancer (PTC), and the remaining 2 had follicular thyroid cancer (FTC). Of the 32 PTC patients, 28 were classical type, 2 patients had the follicular variant, 1 was the oncocytic variant, and 1 was a tall cell variant. Conclusions: The incidence of thyroid cancer was higher in patients who underwent surgery for GD. In addition to a careful physical examination in the follow-up of the patients with GD, ultrasonographic evaluation should be performed. Surgical treatment should not be delayed in patients with GD when indicated.

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Section: Discussionsupporting

confidence: 89%

Frequency of thyroid nodules and thyroid cancer in thyroidectomized patients with Graves’ disease

Çağlar¹,

Şahi̇n²,

Hasanov³

et al. 2020

aoms

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“…Ren and cols. (14) reported this rate to be 3.6% (n = 12). This shows that malignancy is not always related with nodule (12).…”

Section: Resultsmentioning

confidence: 99%

“…In the same study, the total incidence of thyroid cancer was 13.7% (58/423). While thyroid nodule accompanied to 46 of 58 patients, thyroid nodule was absent in 12 (3,6%) patients and the tumor was detected incidentally (14).…”

Section: Resultsmentioning

confidence: 99%

Thyroid nodules and thyroid cancer in Graves’ disease

Tam

Kaya

Kılıç

et al. 2014

Arq Bras Endocrinol Metab

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Objective: The frequency of thyroid nodules accompanying Graves' disease and the risk of thyroid cancer in presence of accompanying nodules are controversial. The aim of this study was to evaluate the frequency of thyroid nodules and the risk of thyroid cancer in patients operated because of graves' disease. Subjects and methods: Five hundred and twenty-six patients in whom thyroidectomy was performed because of Graves' disease between 2006 and 2013 were evaluated retrospectively. Patients who had received radioactive iodine treatment and external irradiation treatment in the neck region and who had had thyroid surgery previously were not included in the study. Results: While accompanying thyroid nodule was present in 177 (33.6%) of 526 Graves' patients, thyroid nodule was absent in 349 (66.4%) patients. Forty-two (8%) patients had thyroid cancer. The rate of thyroid cancer was 5.4% (n = 19) in the Graves' patients who had no nodule, whereas it was 13% (n = 23) in the patients who had nodule. The risk of thyroid cancer increased significantly in presence of nodule (p = 0.003). Three patients had recurrence. No patient had distant metastasis. No patient died during the follow-up period. Conclusions: Especially Graves' patients who have been decided to be followed up should be evaluated carefully during the follow-up in terms of thyroid cancer which may accompany. Arq Bras Endocrinol Metab. 2014;58(9):933-8 Keywords Graves' disease; thyroid nodules; thyroid cancer RESUMO Objetivo: A frequência da ocorrência de nódulos tiroidianos acompanhando a doença de Graves e o risco de câncer de tiroide na presença desses nódulos é controversa. O objetivo deste estudo foi avaliar a frequência de nódulos tiroidianos e o risco de câncer de tiroide em pacientes operados por doença de Graves. Sujeitos e métodos: Quinhentos e vinte e seis pacientes anteriormente submetidos à tiroidectomia por doença de Graves entre 2006 e 2013 foram avaliados retrospectivamente. Os pacientes que receberam tratamento com iodo radioativo e irradiação externa da região do pescoço e que anteriormente passaram por cirurgia de tiroide não foram incluídos no estudo. Resultados: Enquanto os nódulos de tiroide se apresentaram em 177 (33,6%) dos 526 pacientes com doença de Graves, eles estiveram ausentes em 349 (66,4%) pacientes. Um total de 42 (8%) dos pacientes teve câncer de tiroide. A ocorrência de câncer de tiroide foi 5,4% (n = 19) nos pacientes com doença de Graves que não apresentaram nódulos, e 13% (n = 23) nos pacientes com nódulos. O risco de câncer de tiroide aumentou significativamente na presença de nódulos (p = 0,003). Três pacientes apresentaram recidivas. Nenhum paciente apresentou metástase distante e nenhum paciente veio a óbito durante o período de acompanhamento. Conclusões: Pacientes com doença de Graves devem ser avaliados cuidadosamente no acompanhamento para a possível ocorrência de câncer de tiroide. Arq Bras Endocrinol Metab. 2014;58(9):933-8 Descritores Doença de Graves; nódulos tiroidianos; câncer de tiroide

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“…33 Although rates as low as 2.3% was reported in some previous studies, 6 recent studies revealed much higher rates reaching to 13.7%. 34 The prevalence of malignancy in hyperthyroid patients is beyond the scope of our study, however the possibility of an existing tumor before RAI can not be excluded completely. Thus, actual evidence as well as our findings suggests that approach to thyroid nodules in patients with hyperthyroidism whether secondary to Graves or TMNG/TNG should be similar with nodules in euthyroid or hypothyroid patients.…”

Section: Discussionmentioning

confidence: 86%

Evaluation of ultrasonographical and cytological features of thyroid nodules in patients treated with radioactive iodine for hyperthyroidism

Bilginer¹,

Özdemır

Seyrek

et al. 2019

Diagnostic Cytopathology

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Background: In this study, we aimed to evaluate ultrasonographical and cytological features of thyroid nodules in patients who were treated with radioactive iodine (RAI) for hyperthyroidism years ago. Methods:Patients who had a history of RAI treatment for hyperthyroidism and had thyroid nodules that were evaluated with fine-needle aspiration biopsy (FNAB) were included in the study.Results: There were 27 patients (22 female and 5 male) with a mean age of 59.3 ± 13.5.The indication for RAI treatment was Graves in 5 (18.6%), toxic nodular or multinodular goiter in 16 (69.2%), and unknown in 6 (22.2%) patients. A total of 48 thyroid nodules were evaluated with FNAB and cytological diagnosis were benign in 24 (50.0%), nondiagnostic in 15 (31.2%), atypia of undetermined significance in 5 (10.4%), suspicous for malignancy in 2 (4.2%), and malignant in 2 (4.2%) nodules. Thyroidectomy was performed in 10 patients, 5 were benign (50.0%), and 5 (50.0%) were malignant histopathologically. Ultrasonography features of 31 cytologically/histopathologically benign and five cytologically/histopathologically malignant nodules were compared. Prevalence of isoechoic nodules was higher in benign nodules (P = .025). Macrocalcification was observed in 4 (80.0%) of malignant and 10 (32.3%) of benign nodules (P = .042). Conclusion:In patients with a history of RAI treatment for hyperthyroidism, thyroid nodules with suspicious ultrasonography features, particulary hypoechoic appearence and macrocalcification, should be evaluated with FNAB irrespective of the time elapsed after RAI treatment. K E Y W O R D Scytology, fine-needle aspiration biopsy, histopathology, hyperthyroidism, radioactive iodine

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Predictive Factors of Thyroid Cancer in Patients with Graves’ Disease

Abstract: Because the influencing factor of metastatic thyroid cancers in Graves' disease is young age, every suspicious nodule in Graves' disease patients should be evaluated and treated carefully, especially in younger patients because of the potential for metastasis.

Cited by 33 publications

References 39 publications

Frequency of thyroid nodules and thyroid cancer in thyroidectomized patients with Graves’ disease

Frequency of thyroid nodules and thyroid cancer in thyroidectomized patients with Graves’ disease

Thyroid nodules and thyroid cancer in Graves’ disease

Evaluation of ultrasonographical and cytological features of thyroid nodules in patients treated with radioactive iodine for hyperthyroidism

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