Fatih TAŞKESEN, Ömer USLUKAYA, ABDULLAH OĞUZ, Enver AY, Hekim KUZU, Metehan GÜMÜŞ, Sadullah GİRGİN, Bilsel BAÇ

Hipertiroidizm ile tiroid kanseri birlikteliği

Amaç: Tiroid kanseri hipertiroidizmin nedeni olabilen Graves hastalığı, toksik multinodüler guatr veya toksik nodü- ler guatr ile ilişkili olabilir. Bu çalışmanın amacı endemik guatır bölgesi olarak kabul edilen bölgemizde hipertiroidi tanısı almış, tiroidektomi yapılmış ve tiroid kanseri tespit edilen hastaları retrospektif olarak değerlendirmektir. Yöntemler: 2006 ve 2012 yılları arasında hipertiroidili 69 hasta retrospektif olarak incelendi. Klinik hipertiroidizm Triiyodotironin/Tiroksin (T3/T4) seviyelerinin yüksekliği ve TSH düzeyinin düşüklüğü, klinik bulgular ve semptomlar ile tanı konuldu. Cerrahi operasyon için kriterler; malignitenin sitolojik olarak kanıtlanması, guatırın özafagusa veya trakeaya bası semptomlarına neden olması, antitiroid ilaç tedavisinin yan etkileri veya antitiroid ilaçlara cevapsızlıktı. Bulgular: Hastaların 20 (%28,9)de toksik multinodüler guatr, 28 (%40,6)de Graves hastalığı, 21 (%30,5)de toksik nodüler guatr tanısı almış 69 hasta vardı. Bu hastalardan 12 (%17,4)de tiroid kanseri tespit edildi. Sonuç: Hipertiroidili hastalarda malignite ihtimali düşük olsa da şüpheli lezyonlar, nodüller ve boyunda saptanan lenf adenopatiler ayrıntılı olarak incelenmelidir.

Coexistence of hyperthyroidism and thyroid cancer

Objective: Thyroid cancer can be associated with thyrotoxicosis caused by Graves disease, toxic multinodular goiter, or toxic nodular goiter. The aim of this study was considered to be endemic in our region have received the diagnosis of hyperthyroidism, thyroid cancer is detected thyroidectomy performed and patients were retrospectively evaluate. Methods: We retrospectively studied 69 patients assessed for hyperthyroidism between 2006 and 2012. Clinical hyperthyroidism was diagnosed by elevated triiodothyronine/thyroxine (T3/T4) ratios and low thyroidstimulating hormone (TSH) levels, with clinical signs and symptoms. The criteria for surgery were cytological evidence of malignancy, a goiter causing symptoms of tracheal or esophageal compression, side effects of antithyroid drug therapy, or Graves disease with multiple relapses after therapy withdrawal or responsiveness to antithyroid drugs. Results: Totally 69 patients were included. In 20 (28.9%) patients there was toxic multinodular goiter, in 28 (40.6%) Gravess disease, and in 21 (30.5%) patients there was toxic nodular goiter. Of these patients, 12 (17.4%) had thyroid cancer. Conclusion: As a result; low likelihood of malignancy in patients with hyperthyroidism, though suspicious lesions detected in the lymph nodes and neck adenopathies be examined in detail.

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