Popa Oana, Balaș Melania, Golu Ioana, Amzăr Daniela, Varcuș Flore, Cornianu Mărioara, Iacob Mihaela, Popa Valentin-Tudor, Vlad Mihaela
Center of Molecular Research in Nefrology and Vascular Disease, Department of Endocrinology, University of Medicine and Pharmacy "Victor Babeș" Timișoara, 300041 Timișoara, Romania.
Department of Surgery II, University of Medicine and Pharmacy "Victor Babeș" Timișoara, 300041 Timișoara, Romania.
J Clin Med. 2024 Jul 27;13(15):4391. doi: 10.3390/jcm13154391.
Graves' disease (GD) is an autoimmune disorder affecting the thyroid gland, leading to systemic manifestations such as hyperthyroidism, Graves' orbitopathy, and pretibial myxedema. Contrary to previous beliefs that hyperthyroidism protects against thyroid cancer, recent studies reveal an increased incidence of thyroid malignancies in GD patients, particularly differentiated thyroid carcinomas and, in rare cases, medullary thyroid carcinoma (MTC).
This case series presents three female GD patients diagnosed with MTC, highlighting the complexities of diagnosis and management. All patients exhibited thyroid nodules with suspicious ultrasonographic features, elevated plasma calcitonin levels, and required total thyroidectomy. Histological examination confirmed MTC.
These cases underscore the importance of routine calcitonin screening in GD patients with thyroid nodules to facilitate early detection and improve prognosis. Our findings suggest that while the coexistence of GD and MTC is likely incidental, vigilant monitoring and comprehensive evaluation are crucial for timely intervention.
This study advocates for integrating calcitonin testing into the standard diagnostic protocol for GD patients presenting with thyroid abnormalities.
格雷夫斯病（GD）是一种影响甲状腺的自身免疫性疾病，可导致全身症状，如甲状腺功能亢进、格雷夫斯眼病和胫前黏液性水肿。与以往认为甲状腺功能亢进可预防甲状腺癌的观点相反，最近的研究表明，GD患者甲状腺恶性肿瘤的发病率增加，尤其是分化型甲状腺癌，在极少数情况下还包括甲状腺髓样癌（MTC）。
本病例系列介绍了3例诊断为MTC的女性GD患者，突出了诊断和管理的复杂性。所有患者均表现出具有可疑超声特征的甲状腺结节、血浆降钙素水平升高，并需要进行全甲状腺切除术。组织学检查确诊为MTC。
这些病例强调了对有甲状腺结节的GD患者进行常规降钙素筛查以促进早期发现和改善预后的重要性。我们的研究结果表明，虽然GD和MTC的共存可能是偶然的，但警惕的监测和全面的评估对于及时干预至关重要。
本研究主张将降钙素检测纳入有甲状腺异常的GD患者的标准诊断方案中。
