Endocrine Abstracts

Background: Recent reports have mentioned rising incidence of thyroid cancer (TC) detected before and after thyroidec-tomy (Tx) for hyperthyroidism but “hyperfunctioning” TC is however a rare entity.

Patients & Methods: Among a personal series of 464 patients which underwent Tx including 147 (33.6%) cases of thyroto-xicosis and 72 (13.6%) cases of TC, we founded 10 patients with hyperthyroidism and nodular or microscopic TC but only one case of TC with features of thyroid overactivity. History, clinical records, biohormonal picture, imaging studies, pathology findings and surgery notes with follow-up results were analysed.

Results & Discussions: The study enrolles 10 females and one male, age ranged from 16 to 62 years. Concurrent TC was present in 3 cases of Graves’ disease, 5 cases of toxic multinodular goiter and 3 cases of toxic adenoma. None of these patients had recieved previous head or cervical irradiation. One woman underwent elsewere a subtotal Tx 18 years ago. In all but one cases the diagnosis was established by permanent section of the surgical specimen. There were 4 nodules with indeterminate results at frozen section but this procedure furnised a valuable indication in only one case with a follicular sample. Six papillary lesions was microcarcinomas. In the whole group we have 10 papillary and only one follicular cancer. Surgery was the mainstay therapy in all these lesions, the suspicion or presence of cancer imposing the extent of exeresis. Six near-total Tx, 4 hemiTx and one completion Tx were done. Appropriate additional mesures included radioiodine and hormonal therapy in 9 observations. Postoperative results were good with no morbidity and mortality. The long-term study showed 8 cases alive and disease-free in an average follow-up of 60 months.

Conclusion: Hyperthyroidism do not exclude the presence of TC, the latest being crucial for the choice of the surgical strategy and prognosis. The rising number of Tx in cases of hyperthyroidism will probably detect more observations with associated thyroid (micro)carcinoma.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector