THYROID
CANCER IN GRAVES’ DISEASE; IS IT REALY SO RARE?
Thyroid
cancer (TC) in Graves’ disease was originally thought to be rare and Graves’
disease was even considered as “an insurance against cancer of the thyroid”.
However, there is evidence based on the date of recent studies that TC may not
be so rare in Graves’ disease. Current hypotheses of the mechanism of
carcinogenesis in these cases focus on the pathways activated by the binding of
thyroid-stimulating antibodies, which as well as stimulating growth may also
promote invasion and angiogenesis and activate insulin-like growth factor
pathways. The American Thyroid Association (ATA) states that TC occurs in
Graves’ disease with a frequency of 2 % or less. A recent meta-analysis found
that the rate of TC in Graves’ disease is at least double the currently-accepted
2 % (see above, ATA). For patients with Grave’s disease with nodules there
should be a clinical suspicion of TC. These patients are almost 5 times more likely
to be diagnosed with TC than those with Graves’ disease but without thyroid
nodules.
INT J SURG
2016 (27) 118
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