Incidence of thyroid carcinoma in patients with Hashimoto's thyroiditis and solitary cold nodules

Journal Article · Sun Dec 01 04:00:00 EST 1985 · Surgery; (United States)

OSTI ID:5585062

Ott, R A; Calandra, D B; McCall, A; Shah, K H; Lawrence, A M; Paloyan, E

The reported incidence of thyroid carcinoma in Hashimoto's thyroiditis varies widely. For this reason the specific subpopulation of patients with Hashimoto's thyroiditis and a solitary cold nodule was analyzed. Between 1972 and 1984 we operated on 146 consecutive patients with solitary cold nodules and Hashimoto's thyroiditis. There were 47 carcinomas, for an incidence of 32%. The mean age of the 146 patients was 43 1/2 years (median 44 years), with 126 females and 20 males. There was a history of prior head and neck radiation exposure in 54 patients, with a 33% incidence of thyroid carcinoma. The 92 patients without a history of radiation exposure had a 31.5% incidence of carcinoma. The frequency of multicentricity (bilateralism) was 33% in the group that underwent radiation and 24% in the group that did not. To date, with a mean follow-up of 4.7 years, there have been no deaths and no evidence of recurrence. In conclusion, we report a 32% incidence of thyroid carcinoma in patients with Hashimoto's thyroiditis and a solitary cold nodule, with no apparent difference between the patients with or without a history of radiation exposure, although there was a higher incidence of bilateralism (33% versus 24%) in the carcinomas of the patients with a history of head and neck irradiation. We suggest that the operative management of these patients is total thyroidectomy for those with a history of head and neck radiation and thyroid lobectomy for patients with no history of radiation, followed by contralateral lobectomy if a carcinoma is demonstrated.

• OSTI ID: 5585062
• Journal Information: Surgery; (United States), Journal Name: Surgery; (United States) Vol. 6; ISSN SURGA
• Country of Publication: United States
• Language: English

Related Subjects

560151* -- Radiation Effects on Animals-- Man
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
BIOLOGICAL EFFECTS
BIOLOGICAL RADIATION EFFECTS
BODY
BODY AREAS
CARCINOMAS
DISEASES
ENDOCRINE DISEASES
ENDOCRINE GLANDS
GLANDS
HEAD
IRRADIATION
MEDICINE
NECK
NEOPLASMS
ORGANS
PARATHYROID GLANDS
PATIENTS
RADIATION EFFECTS
RADIOINDUCTION
SURGERY
THYROID
THYROIDECTOMY
THYROIDITIS