Endocrine Abstracts

Thyroid cancer (TC) is one of the most frequent neoplasia diagnosed in general population with an estimated incidence of 6.6 cases per 100.000 and mortality of 0.43 cases per 100.000. Differentiated thyroid cancer (DTC), which includes papillary (PTC) and follicular cancer (FTC), comprises the large majority (up to 90%) of all thyroid cancer cases. At the moment etiology of TC is not completely understood, with multiple genetic and epigenetic factor that are thought to be important. We report our recent experience, as a dedicated tertiary care unit in the cure of thalassemia major (TM), that could be useful in the knowledge about induction and progression of carcinogenetic process. TM is a clinical disorder characterized by abnormalities in hemoglobin’s synthesis with main treatment that is characterized by regularly blood transfusion. This therapy usually esitate in iron overload and tissue damage and could be cause of serological viruses transmission (like hepatitis B and C virus or human immunodeficiency virus). In a group of 126 patients affected by TM and studied by neck ultrasound we found thyroid nodules in 36 out of 126 with a prevalence of about 28.5%. Regarding patients affected by thyroid nodules we found 10 cases of TC with a prevalence of nearly 27% of neoplastic lesion that is higher than one reported in general population. Most of TC patients were female, with a median age at diagnosis of 37 years and with an histological picture of papillary in 9 out of 10. Interestingly most of all were affected by relevant endocrine tissue damage (more than 3 endocrinopathy in nearly 80% of cases) giving us the chanche to consider iron overload as a main actor in pathogenesis. Moreover 80% of patients affected by TC showed Hepatitis C virus (HCV) positivity raising the suspicion that HCV infection could perform a relevant role in induction and progression of disease, as previously reported. In conclusion our work would give a key to consider newer pathogenetic aspects in TC induction and progression. These considerations could be relevant especially in some clinical scenario and could be useful in innovative strategy in prevention, diagnosis and treatment.