Hashimoto’s thyroiditis observed in 36% of adults with papillary thyroid carcinoma
Hashimoto’s thyroiditis was found in more than one-third of adults with papillary thyroid carcinoma at a hospital in Turkey, and those with Hashimoto’s thyroiditis were more likely to have a multifocal tumor, according to study data.
“Despite developments in surgical techniques, the underlying causes of papillary thyroid carcinoma have not yet been fully elucidated,” Fatih M. Hanege, MD, assistant professor at Istanbul Medeniyet University School of Medicine, and colleagues wrote in a study published in ACTA Otorhinolaryngologica Italica. “It has not been clearly demonstrated whether papillary carcinoma is a reactive response to Hashimoto’s thyroiditis or if Hashimoto’s thyroiditis is a precursor to papillary thyroid carcinoma development. ... In this study, different from other studies, the rate of Hashimoto’s thyroiditis in patients with papillary thyroid carcinoma was investigated, and 36.1% of 360 patients with papillary thyroid carcinoma had findings of Hashimoto’s thyroiditis in non-neoplastic fields.”
Researchers conducted a retrospective study of 1,080 adults (57.5% women; mean age, 47 years) who were diagnosed with papillary thyroid carcinoma and underwent a thyroidectomy between 1995 and 2017 at Goztepe Training and Research Hospital in Istanbul. Non-neoplastic fields in the pathology specimens for each adult were evaluated for Hashimoto’s thyroiditis. Researchers also evaluated tumor size, extrathyroidal infiltration and multifocality in papillary thyroid carcinoma fields.
Of the study population, 36.1% had Hashimoto’s thyroiditis in non-neoplastic fields. Hashimoto’s thyroiditis was observed in 43.5% of women and 26.2% of men.
Of adults who did not have Hashimoto’s thyroiditis, 83.5% had a unifocal tumor and 16.5% had a multifocal tumor. Of those with Hashimoto’s thyroiditis, 53% had a unifocal tumor and 47% had a multifocal tumor.
There was no significant difference in extrathyroidal tissue invasion between those with and without Hashimoto’s thyroiditis. There were also no differences between the two groups in age, tumor size and lymphovascular infiltration.
“Biopsy of all suspected nodes will increase the probability of making the correct diagnosis in patients scheduled for fine-needle aspiration biopsy,” the researchers wrote. “Lobectomy can be performed as an option in patients who are diagnosed with papillary thyroid carcinoma and have small and single nodules. Since the risk of having multifocal disease is high in Hashimoto’s thyroiditis patients developing papillary thyroid carcinoma, total thyroidectomy should be planned, and a selective neck dissection should be carried out in lymph node-positive patients.”
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