Endocrine Abstracts

Materials and methods: The aims were to evaluate the frequency of nodular thyroid disease (NTD) in acromegalic patients and to correlate clinical and metabolic features with disease activity and other. We conducted a cross-sectional study including retrospectively 69 acromegalic patients attending to an University Hospital in Madrid, Spain between 1980 and 2016. Mean age was 63 (32–92) years, 63.8% of patients were female. Mean age at diagnosis of acromegaly was 48 (11–78) years, time between initial symptoms and diagnosis was 24 (0–240) months, 50 patients (72.5%) had a macroadenoma and 23 (33.8%) were cured after transsphenoidal resection, among the other medical treatment or radiotherapy was necessary for attaining disease control. Thyroid function was normal in 42 patients (60.9%), 22 (31.9%) had hypothyroidism (15 primary, seven secondary) and 5 (7.2%) had hyperthyroidism. NTD were observed in 56 patients (81.2%) and 10 (14.5%) had diffuse goitre. Thyroid volume was 16.1 (4.7–272.7) ml. Fine-needle aspiration biopsy (FNAB) was performed in 17 patients. Suspicious or malignant cytology was detected in 23.5% of the FNABs specimens, all of them (11 patients, 15.9%) underwent thyroidectomy. Pathology revealed nodular goitre in six and thyroid carcinoma in five patients (7.2%). Other cancers detected were colorectal, breast, prostate and gastric in 4 (5.8%), 2 (2.9%), 2 (2.9%) and 1 (1.4%) patients, respectively. Patients with NTD (n=56) showed similar age, duration of disease, thyroid volume, concentrations of GH/IGF-1 at diagnosis and IGF-1 at last follow-up compared with the group of patients without NTD (n=13). Considering only patients with NTD, thyroid volume was not correlated with age, estimated acromegaly duration, time between the first symptoms to diagnosis, fT₄, TSH, GH/IGF-1 at diagnosis or IGF-1 at last follow-up. Thyroid volume was not different whether acromegaly was active or not (17.5 vs 14.3 mm).

Conclusions: Thyroid structural abnormalities are frequent in patients with acromegaly, therefore routine physical examination and thyroid ultrasound are recommended in all of them. Thyroid cancer was the most common neoplasia in our study, which is similar to other reports.