Endocrine Abstracts

Introduction: Graves’ disease is an autoimmune disease that leads to a generalized overactivity of the entire thyroid gland – hyperthyroidism. Although the link between Graves’ disease and thyroid carcinoma was widely explored, we cannot undermine the relationship between this condition and other common neoplasms.

Materials and method: The retrospective analysis was performed using clinical data of 295 adult patients (225 women and 70 men) from our endocrine department in the last five years. Among them, we evaluated 21 with any type of carcinoma (7.11% of all patients with hyperthyroidism, 18 woman and 3 men, aged between 37 and 89 years old) and 79 patients with Graves’ ophtalmopathy. The data was analyzed using IBM SPSS Statistics 20.

Results: The most frequently found 4 types of neoplasms were of thyroid, uterus, breast and dermatological. The prevalence of thyroid cancer in patients with hyperthyroidism varies widely in the literature – from 1.6% to 21.1%. The majority of carcinomas reported in these studies were papillary microcarcinomas. In our analysis we found four cases of thyroid cancer, all four patients being women (19% of all types of cancer) – three papillary microcarcinomas and one papillary-like (NIFPT). Another association mentioned in literature is between hyperthyroidism and breast cancer, as more studies reports the onset of breast cancer especially within three years from the thyropathy diagnosis. In our study, we discovered three cases of breast malignant tumors (14.28% of all types of carcinoma), aged between 52 and 61. Epidemiologic studies also show an association between ovarian cancer and hyperthyroidism, although no mechanism of association was demonstrated. In our analysis, three cases of malignant tumors of the uterus were found (14.28% of all types of carcinoma), aged between 44 and 62. Other malignant tumors were dermatological (three cases – 14.28% of all types of neoplasm), colo-rectal (two cases), pulmonary, renal, prostatic, gastrointestinal (a neuroendocrine tumor), Kaposi Sarcoma and meningioma. Among the 21 patients diagnosed with neoplasms, seven of them (33.33%), all woman, also associated Graves’ ophtalmopathy. A positive statistical correlation was made between the presence of thyroid nodules associated with any type of cancer (P=0.003, r=0.372).

Conclusion: The relationship between common neoplasms (not only thyroid carcinoma) and Graves’ disease is a subject of great interest, our results being limited by the small number of patients. Further investigations, especially between the link to Graves’ ophtalmopathy and pathogenical mechanism should be considered in future studies.

Keywords: Graves’ disease, Graves’ ophtalmopathy, neoplasms