Περίληψη:
Background: Patients with Graves’ disease (GD) and thyroid nodules have
an elevated risk of developing thyroid carcinomas, which is primarily
accounted for by well-differentiated tumors. Among these tumors, certain
histological variants, such as the diffuse sclerosing and tall cell
carcinoma, are characterized by a more aggressive behavior. The aim of
this study was to evaluate the incidence, the clinical behavior in
relation to histological variants, and the outcome of papillary thyroid
carcinoma (PTC) in a cohort of patients with GD who had undergone
thyroidectomy. Methods: A total of 2188 patients who underwent total
thyroidectomy participated in this retrospective, nonrandomized,
population-based study at a General Hospital. Of these patients, 181 had
GD. The parameters examined included the clinical characteristics of the
tumor and the final pathological examination of the thyroid carcinoma.
Results: PTC was diagnosed in 570 patients. Among the 61 with PTC
GD-positive, 59.0% presented with the pure papillary variant, 19.7%
with the follicular variant, 6.6% with the sclerosing variant, and
18.0% with the tall cell variant (TCV) of PTC. Among 509 PTC
GD-negative, 80.6% had pure papillary variant, 9.0% follicular
variant, 3.7% sclerosing variant, and 6.1% TCV. Patients with tumor
size >5 and 10mm demonstrated that lymph node metastasis (p=0.001) and
TCV in histological examination (p=0.003) were statistically
significantly associated with GD-positive PTC. Conclusions: The
incidence of PTC in GD-positive patients is higher than that in
GD-negative patients. Aggressive variants of PTC, such as the TCV, were
more frequent in nodular micro-PTC. These findings suggest that prompt
and meticulous evaluation of nodules in any patient with GD associated
with nodular alterations must be considered.
Συγγραφείς:
Boutzios, Georgios
Vasileiadis, Ioannis
Zapanti, Evangelia and
Charitoudis, Georgios
Karakostas, Efthimios
Ieromonachou,
Panagiotis
Karatzas, Theodore
