Objective To analyze the patients of Graves′ disease with thyroid cancer retrospectively for reference of standardized treatment. Methods Forty-seven patients diagnosed Graves′ disease with thyroid cancer were treated between January 2013 and October 2017. Clinical data, treatments and short outcomes by follow-up were analyzed. Comparison was conducted between 47 cases and thyroid cancer cases without Graves′ disease during same period in our hospital. Results There were 86 cases with Graves′ disease among whom 47(54.7%) were combined with thyroid cancer. It was found that 25 (53.2%) cases with thyroid cancer had Graves′ disease less than 12 months and 11 (23.4%) cases had both 13-48 months and more than 48 months respectively. All 47 cases were performed operations uneventfully. Preoperative potassium iodide was given only 5 cases. No thyroid crisis occurred, and there was no permanent hypoparathyroidism or permanent nerve injury. Only two cases were found cervical lymph node metastasis during the follow-up period of median 14 months. There was no significant difference between the cases with and without Graves′ disease in terms of thyroid microcarcinoma, multifocal tumors and central, lateral lymph node metastasis. Conclusions Graves′ disease with thyroid cancer might not be rare. Increased risk of thyroid cancer was present in patients with shorter course of Graves′ disease. Graves′ disease might not have a significant influence on the aggressiveness of thyroid cancer. The prognosis of thyroid cancer with Graves′ disease is generally favorable.
HUANG Haiyan, KUANG Jie, YING Xiayang, CHEN Xi, YAN Jiqi
. Graves′ disease with thyroid cancer: a report of 47 cases[J]. Journal of Surgery Concepts & Practice, 2018
, 23(06)
: 519
-522
.
DOI: 10.16139/j.1007-9610.2018.06.011
[1] 黄海燕, 翁原驰, 严佶祺, 等. Graves病合并甲状腺癌的研究进展[J]. 外科理论与实践,2016,21(5):446-450.
[2] Gabriella P, Francesco F, Concetto R, et al.Worldwide increasing incidence of thyroid cancer: update on epidemiology and risk factors[J]. J Cancer Epidemiol,2013, 2013:965212.
[3] Staniforth JU, Erdirimanne S, Eslick GD.Thyroid carcinoma in Graves′ disease: A meta-analysis[J]. Int J Surg,2016,27:118-125.
[4] Hancock BW, Bing RF, Dirmikis SM, et al.Thyroid carcinoma and concurrent hyperthyroidism: a study of ten patients[J]. Cancer,1977,39(1):298-302.
[5] Belfiore A, Garofalo MR, Giuffrida D, et al.Increased aggressiveness of thyroid cancer in patients with Graves′ disease[J]. J Clin Endocrinol Metabol,1990,70(4):830-835.
[6] Kraimps JL, Bouin-Pineau MH, Mathonnet M, et al.Multicentre study of thyroid nodules in patients with Graves′ disease[J]. Br J Surg,2000,87(8):1111-1113.
[7] Weber KJ, Solorzano CC, Lee JK, et al.Thyroidectomy remains an effective treatment option for Graves′ disease[J]. Am J Surg,2006,191(3):400-405.
[8] Erbil Y, Barbaros U, Özbey N, et al.Graves′ disease, with and without nodules, and the risk of thyroid carcinoma[J]. J Laryngol Otol,2008,122(3):291-295.
[9] Boutzios G, Vasileiadis I, Zapanti E, et al.Higher incidence of tall cell variant of papillary thyroid carcinoma in Graves′ disease[J]. Thyroid,2014,24(2):347-354.
[10] Tam AA, Kaya C, Kılıç FB, et al.Thyroid nodules and thyroid cancer in Graves′ disease[J]. Arq Bras Endocr Metabol,2014,58(9):933-938.
[11] Kunjumohamed FP, Al-Busaidi NB, Al-Musalhi HN, et al.The prevalence of thyroid cancer in patients with hyperthyroidism[J]. Saudi Med J,2015,36(7):874-877.
[12] Wei S, Baloch ZW, LiVolsi VA. Thyroid carcinoma in patients with Graves′ disease: an institutional experience[J]. Endocr Pathol,2015,26(1):48-53.
[13] Shu X, Ji J, Li X, et al.Cancer risk in patients hospitalised for Graves′ disease: a population-based cohort study in Sweden[J]. Br J Cancer,2010,102(9):1397-1399.
[14] Chen YK, Lin CL, Chang YJ, et al.Cancer risk in patients with Graves′ disease: a nationwide cohort study[J]. Thyroid,2013,23(7):879-884.
[15] Ross DS, Burch HB, Cooper DS, et al.2016 American Thyroid Association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis[J]. Thyroid,2016,26(10):1343-1421.
[16] Shinall MC Jr, Broome JT, Baker A, et al.Is potassium iodide solution necessary before total thyroidectomy for Graves′ disease?[J]. Ann Surg Oncol,2013,20(9):2964-2967.
[17] Yano Y, Shibuya H, Kitagawa W, et al.Recent outcome of Graves′ disease patients with papillary thyroid cancer[J]. Eur J Endocrinol,2007,157(3):325-329.
[18] Pellegriti G, Belfiore A, Giuffrida D, et al.Outcome of differentiated thyroid cancer in Graves′ patients[J]. J Clin Endocrinol Metab,1998,83(8):2805-2809.
[19] Belfiore A, Russo D, Vigneri R, et al.Graves′ disease, thyroid nodules and thyroid cancer[J]. Clin Endocrinol (Oxf),2001,55(6):711-718.
[20] Boi F, Minerba L, Lai ML, et al.Both thyroid autoimmunity and increased serum TSH are independent risk factors for malignancy in patients with thyroid nodules[J]. J Endocrinol Invest,2013,36(5):313-320.
[21] Chao TC, Lin JD, Chen MF.Surgical treatment of thyroid cancers with concurrent Graves′ disease[J]. Ann Surg Oncol,2004,11(4):407-412.
[22] Haugen BR, Alexander EK, Bible KC, et al.2015 Ame-rican Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association Guidelines Task Force on thyroid nodules and differentiated thyroid cancer[J]. Thyroid,2016,26(1):1-133.
