Calapkulu Murat, Sencar Muhammed Erkam, Duger Hakan, Bayram Seyit Murat, Unsal Ilknur Ozturk, Cakal Erman, Ozbek Mustafa
Department of Endocrinology and Metabolism, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
Curr Diabetes Rev. 2020;16(7):787-789. doi: 10.2174/1573399815666191104114551.
İntroduction: Type 1 diabetes mellitus (DM) is characterized by selective autoimmune destruction of pancreatic b-cells, resulting in insulin deficiency and associated autoimmune disorders, such as celiac disease, autoimmune thyroiditis, and gastritis, which can coexist in patients with type 1 DM. These disorders are characterized by the presence of antibodies against tissue transglutaminase, thyroglobulin, and thyroid peroxidase (TPO), as well as against gastric parietal cells. Cross-sectional studies have reported that the risk of autoimmune thyroid diseases in patients with type-1 DM is two- to threefold higher than in the general population. However, there are a few studies in the literature that investigated the relationship between malignancy and type-1 DM, and it has been shown that type-1 DM does not increase thyroid cancer. Furthermore, there is a lot of controversy regarding the role of thyroid autoimmunity in the pathogenesis of thyroid cancer. Here, a type-1 DM patient diagnosed with papillary thyroid cancer is presented. Case Report: Herein, it was aimed to present a 20-year-old female patient diagnosed with type-1 DM and subsequently with papillary thyroid carcinoma (PTC). Thyroid ultrasound revealed a 10×12×18 mm hypoechoic irregular edges nodule with macrocalcification and microcalcification foci in the left lobe and pathological lymph nodes without echogenic hilus were detected at the fourth level of the left cervical chain. Fine needle aspiration biopsy of the nodule was consistent with papillary thyroid carcinoma. Total thyroidectomy, bilateral central lymph node dissection, and left neck dissection (level II to IV) were performed. Pathological examination revealed a 1.4× 0.9 cm diameter papillary carcinoma located in the left lobe of the thyroid gland with 13 lymph node metastases. Conclusion: Patients with type 1 DM should be examined for thyroid diseases, and patients with suspected thyroid disease should be evaluated with a thyroid ultrasound. Type 1 DM and PTC can coexist, albeit very rare. It should be known that type 1 diabetes can be observed together with thyroid cancer.
1型糖尿病（DM）的特征是胰腺β细胞的选择性自身免疫性破坏，导致胰岛素缺乏以及相关的自身免疫性疾病，如乳糜泻、自身免疫性甲状腺炎和胃炎，这些疾病可在1型糖尿病患者中共存。这些疾病的特征是存在针对组织转谷氨酰胺酶、甲状腺球蛋白、甲状腺过氧化物酶（TPO）以及胃壁细胞的抗体。横断面研究报告称，1型糖尿病患者患自身免疫性甲状腺疾病的风险比普通人群高两到三倍。然而，文献中很少有研究调查恶性肿瘤与1型糖尿病之间的关系，并且已经表明1型糖尿病不会增加甲状腺癌的发病率。此外，关于甲状腺自身免疫在甲状腺癌发病机制中的作用存在很多争议。在此，介绍一名诊断为甲状腺乳头状癌的1型糖尿病患者。病例报告：本文旨在介绍一名20岁的女性患者，该患者被诊断为1型糖尿病，随后又被诊断为甲状腺乳头状癌（PTC）。甲状腺超声显示左叶有一个10×12×18毫米的低回声、边缘不规则的结节，伴有粗大钙化和微钙化灶，在左颈链第四级检测到无回声门的病理性淋巴结。结节的细针穿刺活检与甲状腺乳头状癌一致。进行了全甲状腺切除术、双侧中央淋巴结清扫术和左颈部清扫术（II至IV级）。病理检查显示甲状腺左叶有一个直径1.4×0.9厘米的乳头状癌，伴有13个淋巴结转移。结论：1型糖尿病患者应接受甲状腺疾病检查，疑似甲状腺疾病的患者应进行甲状腺超声评估。1型糖尿病和PTC可以共存，尽管非常罕见。应该知道1型糖尿病可以与甲状腺癌同时出现。
