Endocrine Abstracts

Introduction: The association between hyperthyroidism and differentiated thyroid cancer has become increasingly frequent. The etiopathogenesis remains controversial. We report 15 cases of patients, in whom an incidental association with differentiated thyroid cancer was identified.

MaterialS and Methods: Retrospective study over a 37-year period (1986-2023) including 15 patients followed at the Department of Endocrinology and Diabetology for hyperthyroidism, in whom an incidental association with differentiated thyroid cancer was discovered on anatomopathological examination.

Results: The average age was 43.4 years, with a clear female predominance 11W/4M. Nine patients had a toxic nodule, four a basedow’s goiters, and two had graves’s disease, one of whom had a severe graves orbitopathy, who had benefited from corticosteroid boluses and decompression surgery. Total thyroidectomy was performed in all patients, with suspicion of malignancy in the preoperative evaluation in one patient. Histopathological examination revealed papillary carcinoma in four patients, microcarcinoma in nine patients, NIFT-P (Non-Invasive Follicular Thyroid neoplasm with Papillary-like nuclear features) in one patient, and papillary carcinoma with an insular component in one patient, who also had retro-orbital and spinal metastasis. Stage pT1a was the most frequent (9 patients). Iratherapy was indicated in four patients due to multifocality. The outcome was marked by remission in 93% of the patients. One death was recorded in the patient with insular carcinoma.

Conclusions: Based on our series and observations reported in the literature, hyperthyroidism does not guarantee the absence of cancer, and does not eliminate this possibility. The nature of thyroid nodules must be carefully assessed before surgery.