Thyroid carcinoma in subjects with hyperthyroidism

OBJECTIVE: The prevalence of thyroid carcinoma in hyperthyroidism remains c ontroversial. The aim of this retrospective study was to evaluate prevalenc e. PATIENTS AND METHODS: The prevalence of thyroid carcinoma was studied in 86 1 patients operated for clinical or infraclinical hyperthyroidism between 1 992 and 1999. One hundred and fifty patients had a hot nodule, 13 of them w ith an associated goiter. Four hundred five patients had Craves' disease an d 306 had a multinodular goiter. Multiple sections were made in all surgica l specimens for pathology study. RESULTS: Prevalence in solitary nodules was 1.45%. For Craves' disease pati ents, it was 4.1%. Prevalence among patients with multinodular goiter was 4 .9%. Among the cancers, 83% were microcarcinoma. Parathyroid morbidity afte r subtotal and total thyroidectomy was 0.56% and recurrent hyperthyroidism occurred in 1.6%. CONCLUSIONS: These findings are grossly identical to those observed in simp le, nontoxic diffuse multinodular goiter. It would therefore be difficult t o incriminate hyperthyroidism as playing a causal role in the development o f thyroid cancer. These results do however provide an argument favoring tot al or near total thyroidectomy when surgery is performed in patients with h yperthyroidism.