Hakan YABANOĞLU, İlker Murat ARER, Nazım Emrah KOÇER, Abdirahman Sakulen HARGURA, Tevfik AVCI

Graves hastalığında tiroid kanser sıklığının değerlendirilmesi

Amaç: Graves hastalığı ve tiroid kanserleri sık görülen hastalıklar olmasına rağmen her iki hastalığın birlikteliği nadir bir durum olarak karşımıza çıkmaktadır. Bu durumun nadir olmasında hipertiroidinin, tiroid kanserine karşı koruyucu bir etkisinin olduğunu düşündürmektedir. Çalışmamızda graves hastalığı nedeni ile total tiroidektomi uyguladığımız hastalardaki tiroid kanser sıklığını belirlemeyi amaçladık. Gereç ve Yöntem: 2009-2018 yılları arasında graves hastalığı nedeni ile total tiroidektomi yapılan 210 hastanın dosyası geriye dönük olarak incelendi ve patoloji sonucunda tiroid kanseri tanısı alan 38 hasta demografik ve klinik özellikleri açısından değerlendirildi. Bulgular: Hastaların 25’i (%65,8) kadın, 13’ü (%34,2) erkek ve ortalama yaşları 40 (17-68) idi. Ultrasonografik incelemede tüm hastaların (43/210) %20’ de tiroid bezinde nodül varken, patoloji sonucunda karsinom tespit edilen hastaların (22/38) %57’sinde nodül mevcuttu. Tiroidektomi yapılan hastaların patolojik incelemelerinde 38 (%18) hastada tiroid kanseri mevcuttu. Tiroidektomi sonrası 1 hastaya boyun diseksiyonu uygulandı. On iki hastaya radyoaktif iyot tedavisi uygulandı. Ortalama takip süresi 30 (3-108) ay idi. Takiplerde 2 (%5,2) hastada 12. ve 18. aylarda tiroidektomi lojunda papiller kanser nüksü görüldü. Her iki hastaya da RAİ tedavisi uygulandı. Takiplerde nüks izlenmedi. Sonuç: Graves hastalığı ve tiroid kanser birlikteliği nadir olsa da özellikle graves hastalığı nedeni ile takip edilen ve yapılan ultrasonografide nodül bulunan hastalarda mutlaka ince iğne aspirasyon biyopsisi yapılmalıdır. Tiroid dokusunda nodül içeren graves hastalarında cerrahi tedavi seçeneği daha ön planda düşünülmelidir.

Evaluation of thyroid cancer prevalence in patients with graves disease

Aim: Although Graves’ disease and thyroid cancer are commonly occurring diseases, simultaneous occurence is rare. Hyperthyroidism is believed to be protective against thyroid cancer hence the rare simultaneous occurrence. In our study we intend to evaluate thyroid cancer prevalence in patients operated for Graves’ disease in our center. Materials and Methods: Files of 210 patients who underwent total thyroidectomy for Graves’ disease between 2009- 2018 were retrospectively reviewed. Demographic and clinical features of 38 patients with thyroid cancer diagnosis in the pathology report were evaluated. Results: In our study 25 (65.8%) of the patients were women, 13 (34.2%) were men and the average age was 40 (17-68). In ultrasonographic imaging 20% (43/210) of the patients had thyroid nodules, while 57% (22/38) of patients with confirmed carcinoma in the pathologic evaluation had thyroid nodules. Functional neck dissection was performed on1 patient secondary to thyroidectomy. 12 of the patient received radioactive iodine treatment. Our average followup period was 30 (3-108) months. During the follow-up 2 (5.2%) patients had recurrence of papillary cancer in the thryoidectomy area at 12th and 18th months. Both patients received RAI treatment. There was no subsequent recurrence in the follow-up of both the patients.

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