Thyroid cancer in toxic and non-toxic multinodular goiter

Abstract

Background: Many authors have claimed that hyperthyroidism protects against thyroid cancer and believed that the incidence of malignancy is lower in patients with toxic multinodular goiter (TMG) than in those with non-toxic multinodular goiter. But in recent studies, it was reported that the incidence of malignancy with TMG is not as low as previously thought. Aim: To compare the thyroid cancer incidence in patients with toxic and non-toxic multinodular goiter. Settings and Design: Histology reports of patients treated surgically with a preoperative diagnosis of toxic and non-toxic multinodular goiter were reviewed to identify the thyroid cancer incidence. Patients having a history of neck irradiation or radioactive iodine therapy were excluded from the study. Materials and Methods: We reviewed 294 patients operated between 2001-2005 from toxic and non-toxic multinodular goiter. One hundred and twenty-four of them were toxic and 170 were non-toxic. Hyperthyroidism was diagnosed by elevated tri-iodothyroinine / thyroxine ratios and low thyroid-stimulating hormone with clinical signs and symptoms. All patients were evaluated with ultrasonography and scintigraphy and fine needle aspiration biopsy. Statistical Analysis Used: Significance of the various parameters was calculated by using ANOVA test. Results: The incidence of malignancy was 9% in the toxic and 10.58% in the non-toxic multinodular goiter group. Any significant difference in the incidence of cancer and tumor size between the two groups could not be detected. Conclusions: The incidence of malignancy in toxic multinodular goiter is not very low as thought earlier and is nearly the same in non-toxic multinodular goiter.

ANIMAL MODELS OF DISEASE: Feline hyperthyroidism: an animal model for toxic nodular goiter

“…However, the prevalence of malignancy developing within a feline goiter appears to increase progressively over time, especially if the toxic goiter is not definitively treated with thyroidectomy or radioiodine (Peterson 2012, Broome & Peterson 2014, Peterson & Broome 2014a. A similar prevalence of thyroid cancer is also reported in humans with toxic nodular goiter (Sokal 1954, Gandolfi et al 2004, Cerci et al 2007, Khan & Nose 2010. In both man and cats, the thyroid Histologic section across a nodular goiter of a hyperthyroid cat stained with periodic acid-Schiff (PAS).…”

Thyroid Cancer in Patients with Hyperthyroidism

“…However, the data available in the literature regarding the incidence and the evolution of the disease are controversial. Cerci et al found no signifi cant diff erence for the incidence of thyroid cancer between toxic and nontoxic multinodular goiter [ 92 ] . In another study, lymph node involvement was found in 23 % of the cases with toxic multinodular goiter and cancer [ 17 ] .…”

Prevalence of Thyroid Carcinoma in Clinically Diagnosed Multinodular Goitre in a Tertiary Care Centre- A Retrospective Descriptive Study

“…Since neoplastic transformation is a multistep process that results in a continuous spectrum from the normal (physiological) state to a fully established neoplasm. 21,22 Thyroid Carcinoma (TC) is a relatively rare tumour, but it represents the most frequent form of cancer of the endocrine glands. Epidemiologically ascertained risk factors are ionising radiation, the presence of thyroid adenoma and Multinodular Goitre (MNG).…”