title: Benign and malignant nodular thyroid disease in acromegaly. Is a routine thyroid ultrasound evaluation advisable?
abstract: Data on the prevalence of benign and malignant nodular thyroid disease in patients with acromegaly is a matter of debate. In the last decade an increasing incidence of thyroid cancer has been reported. The aim of this study was to evaluate the prevalence of goiter, thyroid nodules and thyroid cancer in a large series of patients with acromegaly with a cross-sectional study with a control group. Six Spanish university hospitals participated. One hundred and twenty three patients (50% men; mean age 59±13 years; disease duration 6.7±7.2 years) and 50 controls (51% males, mean age 58±15 years) were studied. All participants underwent thyroid ultrasound and fine needle aspiration. Cytological analysis was performed in suspicious nodules between 0.5 and 1.0 cm and in all nodules greater than 1.0 cm. Goiter was more frequently found in patients than in controls (24.9 vs. 8.3%, respectively; p<0.001). Nodular thyroid disease as well as nodules greater than 1 cm were also more prevalent in acromegalic patients (64.6%, vs. 28.6%, p<0.05 and 53.3 vs. 28.6%, respectively; p<0.05), and all underwent fine needle aspiration. Suspicious cytology was detected in 4 patients and in none of the controls. After thyroidectomy, papillary thyroid carcinoma was confirmed in two cases (3.3% of patients with thyroid nodules), representing 1.6% of the entire group of patients with acromegaly (2.4% including a case with previously diagnosed papillary thyroid carcinoma). These data indicated that thyroid nodular disease and cancer are increased in acromegaly, thus justifying its routine ultrasound screening.
authors.affiliation: Service of Endocrinology and Nutrition, Department of Medicine, Germans Trias i Pujol Health Science Research Institute and Hospital, Universitat Autònoma de Barcelona, Badalona, Spain.
authors.forename: Jordi L
authors.initials: JL
authors.lastname: Reverter
authors.affiliation: Service of Endocrinology, Hospital Universitario de la Ribera, Alzira, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Fajardo
authors.affiliation: IIB- Sant Pau and Service of Endocrinology, Department of Medicine, Centro de Investigación Biomédica en Enfermedades Raras (CIBER-ER Unidad 747), Hospital Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Eugenia
authors.initials: E
authors.lastname: Resmini
authors.affiliation: Service of Endocrinology and Nutrition, Department of Medicine, Germans Trias i Pujol Health Science Research Institute and Hospital, Universitat Autònoma de Barcelona, Badalona, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Salinas
authors.affiliation: Service of Endocrinology, Hospital Clínic, Barcelona, Spain.
authors.forename: Mireia
authors.initials: M
authors.lastname: Mora
authors.affiliation: Service of Pathology, Department of Medicine, Germans Trias i Pujol Health Science Research Institute and Hospital, Universitat Autònoma de Barcelona, Badalona, Spain.
authors.forename: Mariona
authors.initials: M
authors.lastname: Llatjós
authors.affiliation: Service of Endocrinology, Hospital Universitari Quiron-Dexeus, Barcelona, Spain.
authors.forename: Gemma
authors.initials: G
authors.lastname: Sesmilo
authors.affiliation: Service of Endocrinology, Hospital Universitari Arnau de Vilanova, Lleida, Spain.
authors.forename: Ferran
authors.initials: F
authors.lastname: Rius
authors.affiliation: Service of Endocrinology, Hospital Clínic, Barcelona, Spain.
authors.forename: Irene
authors.initials: I
authors.lastname: Halperin
authors.affiliation: IIB- Sant Pau and Service of Endocrinology, Department of Medicine, Centro de Investigación Biomédica en Enfermedades Raras (CIBER-ER Unidad 747), Hospital Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Webb
authors.affiliation: Service of Radiology, Hospital Universitario de la Ribera, Alzira, Spain.
authors.forename: Veronica
authors.initials: V
authors.lastname: Ricart
authors.affiliation: Service of Neurosurgery, Hospital Universitario de la Ribera, Alzira, Spain.
authors.forename: Pedro
authors.initials: P
authors.lastname: Riesgo
authors.affiliation: Service of Endocrinology and Nutrition, Department of Medicine, Germans Trias i Pujol Health Science Research Institute and Hospital, Universitat Autònoma de Barcelona, Badalona, Spain.
authors.forename: Dídac
authors.initials: D
authors.lastname: Mauricio
authors.affiliation: Service of Endocrinology and Nutrition, Department of Medicine, Germans Trias i Pujol Health Science Research Institute and Hospital, Universitat Autònoma de Barcelona, Badalona, Spain.
authors.forename: Manel
authors.initials: M
authors.lastname: Puig-Domingo
mesh_terms: D000172:Acromegaly / Q000150:complications* / Q000175:diagnosis; D000368:Aged; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D013961:Thyroid Gland / Q000000981:diagnostic imaging / Q000473:pathology; D013964:Thyroid Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology*; D016606:Thyroid Nodule / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology*; D014463:Ultrasonography