To evaluate whether coexistence of Gravesâ disease affects the prognosis of thyroid cancer we examined the clinical and pathological characteristics of 22 differentiated thyroid carcinomas concomitant with hyperthyroidism; 13 were associated with Gravesâ disease, and 9 with autonomous thyroid nodules. Carcinomas were identified in a consecutive series of 359 hyperthyroid patients (132 with Gravesâ disease and 227 with autonomous thyroid nodules) who underwent surgery during a 6-yr period. One hundred and thirty-seven thyroid carcinomas were found in the 582 euthyroid patients operated on in the same period. In Gravesâ patients, carcinomas were more often multifocal (46.1% vs. 0%), locally invasive (61.5% vs. 11.1%), and met-astatic to lymph nodes (61.5% vs. 11.1%) or to distant sites (23.0% vs. 0%) than in patients with autonomous thyroid nodules. In addition, carcinomas concomitant with Gravesâ disease were larger (3.3 Â± 1.8 vs. 1.0 Â± 0.7 cm) than the ones associated with autonomous thyroid nodules and showed a high recurrence rate. In euthyroid patients, aggressiveness of thyroid cancer was intermediate. Serum TSH levels were suppressed in all hyperthyroid patients with thyroid cancer. However, circulating thyroid-stimulating antibodies were present in 12 of 13 cancer patients with Gravesâ disease, but were absent in patients with autonomous thyroid nodules. Our study suggests, therefore, that TSAb may play a role in determining the high aggressiveness of thyroid cancer in Gravesâ disease patients and indicates that a vigorous treatment should be pursued in this subgroup of patients. Â© 1990 by The Endocrine Society.
|Titolo:||Increased aggressiveness of thyroid cancer in patients with gravesâ disease|
BELFIORE, Antonino (Corresponding)
|Data di pubblicazione:||1990|
|Appare nelle tipologie:||1.1 Articolo in rivista|