Calò Pietro Giorgio, Tatti Alberto, Farris Stefania, Malloci Armando, Nicolosi Angelo
Dipartimento di Chirurgia, Policlinico Universitario, Università degli Studi, Cagliari.
Chir Ital. 2005 Mar-Apr;57(2):193-7.
The relationship between hyperthyroidism and thyroid carcinoma remains controversial. In hyperthyroid patients the incidence of thyroid cancer varies considerably from 0.1% to 21%. We analyzed the frequency of coexisting hyperthyroidism and thyroid malignancy in our experience. From September 2002 to June 2004, 450 patients were submitted to total thyroidectomy in our surgical department. Hyperthyroidism was observed in 71 cases and thyroid carcinoma in 110 (107 differentiated). The association of hyperthyroidism and thyroid cancer was observed in 15 patients (14% of differentiated carcinomas and 21.1% of hyperthyroid patients). All patients were submitted to total thyroidectomy and are alive and disease-free. Seven cases of transitory hypoparathyroidism were observed (46.6%). There was no other morbidity. The association of thyroid cancer and hyperthyroidism is by no means rare. Careful exami- nation of hyperthyroid patients is always necessary to exclude the presence of carcinoma. These results confirm that the operation should be total thyroidectomy when surgery is performed in patients with hyperthyroidism.
甲状腺功能亢进症与甲状腺癌之间的关系仍存在争议。在甲状腺功能亢进症患者中，甲状腺癌的发病率差异很大，从0.1%到21%不等。我们根据自身经验分析了甲状腺功能亢进症与甲状腺恶性肿瘤并存的频率。2002年9月至2004年6月，我们外科有450例患者接受了甲状腺全切除术。其中71例存在甲状腺功能亢进症，110例患有甲状腺癌（107例为分化型）。15例患者同时存在甲状腺功能亢进症和甲状腺癌（占分化型癌的14%，甲状腺功能亢进症患者的21.1%）。所有患者均接受了甲状腺全切除术，目前均存活且无疾病。观察到7例暂时性甲状旁腺功能减退（46.6%）。无其他并发症。甲状腺癌与甲状腺功能亢进症的并存绝非罕见。对甲状腺功能亢进症患者进行仔细检查以排除癌的存在总是必要的。这些结果证实，对甲状腺功能亢进症患者进行手术时应行甲状腺全切除术。
