Thyroid Cancer and Nodules in Graves’ Disease: A Single Center Experience

(E-pub Ahead of Print)

Author(s): Claudio Casella, Riccardo Morandi*, Apollonia Verrengia, Alessandro Galani, Sarah Molfino, Dhimiter Cuka, Giacomo Groppo, Carlo Cappelli, Nazario Portolani

Journal Name: Endocrine, Metabolic & Immune Disorders - Drug Targets
Formerly Current Drug Targets - Immune, Endocrine & Metabolic Disorders


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Abstract:

Background: The existence of a link between Graves’ Disease (GD) and Thyroid Cancer (TC) has long been investigated, however a clear pathogenic correlation is yet to be found.

Methods: In this study we analyzed retrospectively a cohort of 151 patients treated at our clinic with total thyroidectomy between 2013 and 2018. All the patients were symptomatic at the time of surgery, preoperatively ultrasonographic (US) study was performed to evaluate the presence of nodules and their distribution. All patients reached euthyroid state before surgery.

Objective: We verified the presence of TC in patients submitted to surgery for GD, both with and without thyroid nodules (TN).

Results: Nodules were detected in 53% of cases, above 60 years of age, at least one nodule was found; however, younger patients were mostly nodules free. Bilateral diffusion of nodules appeared with increasing age. Cancer was found in 19 of 151 subjects (12.5%), all were papillary carcinomas, and among them 93% were microcarcinomas. Among cancer-proven patients, 14 had thyroid nodules while 5 were nodule-free. During the follow up period, no cancer recurrence was recorded. The most common complication after surgery was transient hypocalcemia (36%).

Conclusions: Graves’ patients are burdened by major incidence of TC in the context of their TN. Pre-operative assessment in GD patients should consider the risk of cancer, US scan can help in rapid evaluation of nodules and new rising frontiers in molecular biomarkers analysis may help defining pathogenic basis of Graves’ neoplastic development.

Keywords: Thyroid, nodules, Graves’ disease, cancer, surgery, thyroidectomy.

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Article Details

Published on: 29 December, 2020
(E-pub Ahead of Print)
DOI: 10.2174/1871530321666201230111911
Price: $95

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