R Daou1. 1. Service de chirurgie générale, hôpital Saint-Georges, Beyrouth, Liban.
Abstract
STUDY AIM: The idea that thyrotoxicosis is insurance against thyroid cancer has prevailed for a long time. However this association has been reported frequently in the recent literature. The aim of this study is to report our experience concerning this association and to discuss its incidence and its consequences in the light of the present data. PATIENTS AND METHOD: Among the 734 patients who underwent a thyroidectomy between January 1983 and January 1998, there were 125 patients with hyperthyroidism, ten with associated cancer (8%). All patients were female (mean age: 43.8 years) with Graves' disease (n = 2), a toxic adenoma (n = 5), or a multi nodular toxic goiter (n = 3). The cancer was recognized intraoperatively in eight patients. A total thyroidectomy was performed in five cases and a total lobectomy associated with a subtotal contralateral lobectomy in five cases, completed by a treatment with l131 in nine cases. RESULTS: Concurrent carcinoma was present in 10% of the patients with toxic nodular goiter and in 4.4% in those with Graves' disease. Papillary carcinoma presented in all cases. The size of the cancer was between 0.2 and 1.5 cm. Nodal involvement was present in one patient. With a follow-up of 1 to 15 years, there was no local recurrence and no metastasis. CONCLUSION: The diagnosis of hyperthyroidism does not preclude concurrent thyroid carcinoma. The prognostic and therapeutic consequences of this association are still debated.
STUDY AIM: The idea that thyrotoxicosis is insurance against thyroid cancer has prevailed for a long time. However this association has been reported frequently in the recent literature. The aim of this study is to report our experience concerning this association and to discuss its incidence and its consequences in the light of the present data. PATIENTS AND METHOD: Among the 734 patients who underwent a thyroidectomy between January 1983 and January 1998, there were 125 patients with hyperthyroidism, ten with associated cancer (8%). All patients were female (mean age: 43.8 years) with Graves' disease (n = 2), a toxic adenoma (n = 5), or a multi nodular toxic goiter (n = 3). The cancer was recognized intraoperatively in eight patients. A total thyroidectomy was performed in five cases and a total lobectomy associated with a subtotal contralateral lobectomy in five cases, completed by a treatment with l131 in nine cases. RESULTS: Concurrent carcinoma was present in 10% of the patients with toxic nodular goiter and in 4.4% in those with Graves' disease. Papillary carcinoma presented in all cases. The size of the cancer was between 0.2 and 1.5 cm. Nodal involvement was present in one patient. With a follow-up of 1 to 15 years, there was no local recurrence and no metastasis. CONCLUSION: The diagnosis of hyperthyroidism does not preclude concurrent thyroid carcinoma. The prognostic and therapeutic consequences of this association are still debated.