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Thyroid Cancer With Coexistent Hashimoto's Thyroiditis: Clinical Assessment and Management

Thyroid Cancer With Coexistent Hashimoto's Thyroiditis: Clinical Assessment and Management Abstract • Hashimoto's thyroiditis is a common thyroid disorder. Because of the difficulty of diagnosing a coexisting thyroid cancer, its management remains controversial. We reviewed 120 cases of thyroid cancer seen in our institution during an 11-year period (1976 through 1986) and defined the clinical characteristics of patients with both entities. Thirteen patients had concomitant cancer and Hashimoto's thyroiditis. Six of the 13 patients had a history of thyroiditis before the diagnosis of thyroid cancer. The remaining seven patients had evidence of Hashimoto's thyroiditis on histologic review of the thyroid specimen. The two most common characteristics prompting surgical intervention were the presence of a nonsuppressing dominant nodule and a cold area on thyroid scan. Twelve patients underwent preoperative fine-needle aspiration cytologic examination, but only in three were the results considered to be indicative of cancer. All 13 patients remained disease free. Despite the apparent indolence of thyroid cancer associated with Hashimoto's thyroiditis, selective surgical treatment of patients with clinical thyroiditis is indicated. (Arch Surg 1989;124:1045-1047) References 1. Dailey ME, Lindsay S, Skahen R: Relation of thyroid neoplasms to Hashimoto's disease of the thyroid gland . Arch Surg 1955;70:291-297.Crossref 2. Woolner LB, McConahey WM, Beahrs OH: Struma lymphomatosa (Hashimoto's thyroiditis) and related thyroidal disorders . J Clin Endocrinol Metab 1959;19:53-83.Crossref 3. Hirabayashi RN, Lindsay S: The relation of thyroid carcinoma and chronic thyroiditis . Surg Gynecol Obstet 1965;121:243-252. 4. Holm L, Blomgren H, Lowhagen T: Cancer risks in patients with chronic lymphocytic thyroiditis . N Engl J Med 1985;312:601-604.Crossref 5. Hamburger J: The various presentations of thyroiditis . Ann Intern Med 1986;104:219-224.Crossref 6. Segal K, Ben-Bassat M, Avraham A, et al: Hashimoto's thyroiditis and carcinoma of the thyroid gland . Int Surg 1985;70:205-209. 7. Holms H, Kreutner A, O'Brien P: Hashimoto's thyroiditis and its relationship to other thyroid diseases . Surg Gynecol Obstet 1977;144:887-890. 8. Crile G: Struma lymphomatosa and carcinoma of the thyroid . Surg Gynecol Obstet 1978;147:350-352. 9. Ott R, McCall A, McHenry C, et al: The incidence of thyroid carcinoma in Hashimoto's thyroiditis . Am Surg 1987;53:442-445. 10. Clark O, Greenspan F, Dunphy J: Hashimoto's thyroiditis and thyroid cancer: Indications for operation . Am J Surg 1980;140:65-71.Crossref 11. Meier D, Woolner L, Beahrs O, et al: Parenchymal findings in thyroidal carcinoma: Pathologic study of 256 cases . J Clin Endocrinol 1959;19:162-171.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Thyroid Cancer With Coexistent Hashimoto's Thyroiditis: Clinical Assessment and Management

Archives of Surgery , Volume 124 (9) – Sep 1, 1989

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Publisher
American Medical Association
Copyright
Copyright © 1989 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1989.01410090055012
Publisher site
See Article on Publisher Site

Abstract

Abstract • Hashimoto's thyroiditis is a common thyroid disorder. Because of the difficulty of diagnosing a coexisting thyroid cancer, its management remains controversial. We reviewed 120 cases of thyroid cancer seen in our institution during an 11-year period (1976 through 1986) and defined the clinical characteristics of patients with both entities. Thirteen patients had concomitant cancer and Hashimoto's thyroiditis. Six of the 13 patients had a history of thyroiditis before the diagnosis of thyroid cancer. The remaining seven patients had evidence of Hashimoto's thyroiditis on histologic review of the thyroid specimen. The two most common characteristics prompting surgical intervention were the presence of a nonsuppressing dominant nodule and a cold area on thyroid scan. Twelve patients underwent preoperative fine-needle aspiration cytologic examination, but only in three were the results considered to be indicative of cancer. All 13 patients remained disease free. Despite the apparent indolence of thyroid cancer associated with Hashimoto's thyroiditis, selective surgical treatment of patients with clinical thyroiditis is indicated. (Arch Surg 1989;124:1045-1047) References 1. Dailey ME, Lindsay S, Skahen R: Relation of thyroid neoplasms to Hashimoto's disease of the thyroid gland . Arch Surg 1955;70:291-297.Crossref 2. Woolner LB, McConahey WM, Beahrs OH: Struma lymphomatosa (Hashimoto's thyroiditis) and related thyroidal disorders . J Clin Endocrinol Metab 1959;19:53-83.Crossref 3. Hirabayashi RN, Lindsay S: The relation of thyroid carcinoma and chronic thyroiditis . Surg Gynecol Obstet 1965;121:243-252. 4. Holm L, Blomgren H, Lowhagen T: Cancer risks in patients with chronic lymphocytic thyroiditis . N Engl J Med 1985;312:601-604.Crossref 5. Hamburger J: The various presentations of thyroiditis . Ann Intern Med 1986;104:219-224.Crossref 6. Segal K, Ben-Bassat M, Avraham A, et al: Hashimoto's thyroiditis and carcinoma of the thyroid gland . Int Surg 1985;70:205-209. 7. Holms H, Kreutner A, O'Brien P: Hashimoto's thyroiditis and its relationship to other thyroid diseases . Surg Gynecol Obstet 1977;144:887-890. 8. Crile G: Struma lymphomatosa and carcinoma of the thyroid . Surg Gynecol Obstet 1978;147:350-352. 9. Ott R, McCall A, McHenry C, et al: The incidence of thyroid carcinoma in Hashimoto's thyroiditis . Am Surg 1987;53:442-445. 10. Clark O, Greenspan F, Dunphy J: Hashimoto's thyroiditis and thyroid cancer: Indications for operation . Am J Surg 1980;140:65-71.Crossref 11. Meier D, Woolner L, Beahrs O, et al: Parenchymal findings in thyroidal carcinoma: Pathologic study of 256 cases . J Clin Endocrinol 1959;19:162-171.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Sep 1, 1989

References