Hyperthyroidism and concurrent thyroid cancer

Aims and background: The aim of this study was to analyze the frequency of coexisting hyperthyroidism and thyroid malignancy in endemic goiter areas a nd review the current literature on the subject. Methods: During the period January 1984 to June 1998, 1853 patients were ex amined for hyperthyroidism at the Spedali Civili Hospital of Brescia, Italy ; 512 (27.6%) subjects underwent surgery. Of these patients 108 (21%) had G raves' disease, 251 (49%) multinodular toxic goiter (MTG) and 153 (30%) uni nodular toxic goiter (UTG), Results: Malignancy was found in 24 (4.7%) patients: 19 females and 5 males with a mean age of 52.2 years (range, 21-76 years). The frequency of cance r in Graves' disease was 6.4%, 5 females and 2 males; in MTG 3.9%, 2 female s and 8 males, and in UTG 4.4%, 7 females and 1 male. Conclusions: Our data confirm previous reports on the frequency of thyroid cancer in hyperthyroidism. This association is more relevant than previousl y suspected. The frequent coexistence of hyperthyroidism and neoplasia, dem onstrated by our study and the most recent literature, underlines the impor tance of studying and excluding the possibility of neoplastic degeneration by means of a systematic approach.