Thyroid cancer in patients with hyperthyroidism.
OBJECTIVE
The coexistence of hyperthyroidism and thyroid cancer is considered a rare event. With the aim of assessing the clinical relevance of this association, we have retrospectively analyzed the incidence of thyroid cancer in 425 hyperthyroid patients seen and treated by surgery in our institutions.


METHODS
Among these hyperthyroid patients, we observed 241 (56.7%) cases of multinodular toxic goiter, 120 (28.3%) of uninodular toxic goiter and 64 (15%) cases of Graves' disease.


RESULTS
Thyroid cancer was diagnosed in 7 (1.65%) hyperthyroid patients. Histological examination revealed the presence of papillary carcinoma in 5 cases and follicular carcinoma in 2 cases. Neoplasia was detected in 4 patients with nodular toxic goiter and in 3 with uninodular toxic goiter. None of the patients with Graves' disease had thyroid cancer. During the follow-up of 74 months (range 4-154), there were no deaths or any recurrences.


CONCLUSIONS
Although the occurrence of thyroid cancer in hyperthyroid patients is a rare event, the presence of a 'cold' nodule in a hyperfunctioning thyroid should be carefully evaluated to exclude the presence of concurrent malignancy.
Gabriele
Raimondo
R
Department of Surgery Pietro Valdoni, University of Rome La Sapienza, Rome, Italy.
Letizia
Claudio
C
Borghese
Mario
M
De Toma
Giorgio
G
Celi
Massimiliano
M
Izzo
Luciano
L
Cavallaro
Antonio
A
D018263:Adenocarcinoma, Follicular / Q000473:pathology; D000328:Adult; D000368:Aged; D002291:Carcinoma, Papillary / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006044:Goiter, Nodular / Q000150:complications / Q000473:pathology; D006111:Graves Disease / Q000150:complications / Q000473:pathology; D006801:Humans; D006980:Hyperthyroidism / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology*; D014465:Ultrasonics; D014463:Ultrasonography