Endocrine Abstracts

Aim: There are some studies suggesting that the risk of developing cancers,especially thyroid cancer, is increased in the patients with acromegaly. The prevalence of thyroid cancer is 1.2-10.6% among the patients with acromegaly. In this study, we aimed to evaluate clinical and histopathologic characteristics of thyroid cancer among the patients with acromegaly.

Method: We retrospectively evaluated the patients with acromegaly who had been followed-up by our department between the years 2005 and 2016 and diagnosed with thyroid cancer.

Results: 9 (81.8%) of 11 subjects were female and 2 (18.2%) patients were male. The mean age of the patients at the time of acromegaly diagnosis was 41±11years. Among subjects who had been followed for 11.45±9.37 years, all except one patient were not in remission and were receiving medical treatment. All subjects were diagnosed with thyroid cancer after the diagnosis of acromegaly and the mean time until the diagnosis of thyroid cancer was.27±9.23 years. In terms of thyroid hormone status, nine subjects were euthyroid and two patients were found to have central hypothyroidism. Thyroid ultrasonographic examination revealed multinodular goiter in all patients. Thyroid fine needle aspiration biopsy was performed for nodules bigger than 1 cm or nodules with malignancy criteria. Thyroid fine needle aspiration biopsy demonstrated undetermined atypia in 27.3%, suspicious follicular neoplasia in 36.4%, follicular neoplasia in 9.1% and suspicious malignancy in 27.32% of the subjects. All patients underwent total thyroidectomy. Pathological examination of thyroid tissue revealed follicular variant papillary thyroid cancer in 5, classic and follicular variant papillary thyroid cancer in 3, diffuse sclerosing variant papillary thyroid cancer in 1, solid variant papillary thyroid cancer in 1 and follicular, classic and clear cell papillary thyroid cancer in one patient. 72.7% of the patients had multifocal disease and 63.7% of the subjects had unilateral disease. Lymphovascular invasion and extrathyroidal extension were present in 9.1 and 18.2% of the subjects, respectively. No distant or local metastasis was detected during mean follow-up period of 28.72±16.18 months.

Conclusion: Patients with acromegaly should be considered for the presence of thyroid cancer.