Endocrine Abstracts

Introduction: Papillary thyroid carcinoma is the most common form of thyroid cancer. It is differentiated, slow growing and usually has a good prognosis. Its risk factors are not all identified; we note exposure to radiation, particularly ionising radiation, and certain genetic mutations which are currently being explored. The aim of our work is to study the relationship between papillary thyroid carcinoma and cervical cancer.

Observation: We report the case of a 65-year-old female patient, type two diabetic and hypertensive, followed since 2016 for FIGO stage 1A2 cervical cancer revealed by a screening cervico-vaginal smear. The patient underwent a conization of the cervix with clinical, biological and radiological monitoring. The evolution was marked, 2 years later, by the appearance of a clinically suspicious thyroid nodule. Ultrasound showed a 6 mm nodule classified as tirads 5. She underwent total thyroidectomy and the result of the anatomopathological examination was in favour of a papillary microcarcinoma classified as Pt1a NxMx with low risk of recurrence. The outcome was good on L-thyroxine.

Discussion: Papillary thyroid carcinoma is often revealed by a thyroid nodule or cervical adenopathy. However, in cancer patients, it is usually revealed by a radiological image at the time of extension or follow-up. A French cohort from the hospital in Rennes showed that women with a history of uterine fibroid and/or hysterectomy are at higher risk of differentiated thyroid carcinoma. The hyperestrogenic environment could be one of the underlying pathophysiological mechanisms. (1) In our case, it is rather the papillomavirus that can possibly be incriminated.

Conclusion: Uterine pathologies are increasingly associated with the risk of incidence of differentiated thyroid carcinoma. In the light of our observation, it will be interesting to carry out a prospective study of patients followed up for cervical cancer in search of papillary thyroid carcinoma; in order to establish the link with papillomavirus.

References: (1) A. Guenego, Des antécédents d’hystérectomie et de fibrome utérin sont associés au risque d’incidence du cancer différencié de la thyroïde chez la femme dans la cohorte E3N, service d’endocrinologie, diabétologie et nutrition, CHU de Rennes, Rennes, France, Annales d’endocrinologie, Volume 77, Issue 4, September 2016, Page 287.