ECE2023 Eposter Presentations Thyroid (128 abstracts)
Thyroid cancer yield in patients with Graves’ disease
Souha Kallel 1 , Faten Haj Kacem Akid 2 , Imen Achour 1 , Slim Charfi 3 , Hamdi Frikha 2 , Mohamed Abid 2 & Ilhem Charfeddine 1
1Habib Bourguiba Hospital, Department of Otolaryngology (ENT) Head and Neck Surgery, Sfax, Tunisia, 2Hedi Chaker Hospital, Department of Endocrinology, Sfax, Tunisia, 3Habib Bourguiba Hospital, Department of Pathology, Sfax, Tunisia
Background: Thyroid nodules found in patients with Graves’ disease have a higher likelihood of being malignant. Management of these association is controversial.
Objectives: To discuss clinical and therapeutic features of this association.
Materials and methods: We report three cases of thyroid cancer occurring in Graves’ disease, treated surgically at our department.
Results: There were three patients, aged respectively 19, 20 and 49 years, addressed for surgical management of a Graves’ disease resistant to medical treatment. The exam found Homogeneous goitre in all cases, firm and hard nodules in two cases. scintigraphy showed cold nodules and ultrasound suspected malignancy in only one case. Histopathological examination concludes to a papillary carcinoma in all cases (from 0,5 to 2,5 cm) including one with Extra thyroid invasion and Metastatic central lymph adenopathy. All patients received a total thyroidectomy and Radioactive iodine therapy. One patient had central and lateral neck dissection. Evolution was a complete remission in all cases.
Conclusion: Prevalence of thyroid cancer in Graves’ patients is 0.4% to 10%. It is explained by the stimulating action of the anti TSH antibodies on adenylcyclase. The characteristics of this association are: higher incidence of papillary carcinoma and multi focality, extra thyroid invasion, lymph node metastasis, loco regional and distant recurrence. Ultrasonography should be used routinely to detect any associated nodule. Fine needle aspiration has an important place in the monitoring of these nodules. Total thyroidectomy with histopathological study is indicated at the slightest sign of malignancy.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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