Endocrine Abstracts

Introduction: Thyroid malignancy associated with hyperthyroidism is considered rare. Retrospective studies have shown the incidence of thyroid malignancy in hyperthyroid patients to be low (0.7–8.5%). To assess the clinical relevance of this association, thyroid status in a cohort of patients with thyroid malignancy were analysed.

Method: Thyroid malignancies diagnosed histologically in 56 patients, over a 18-month period beginning from April 2013, in a single surgical unit at Teaching Hospital Kandy were included. Preoperative patient details and progression of thyroid status were asessed with TSH, free thyroxine, and free triiodothyronine levels.

Results: Amongst 56 patients papillary carcinoma was diagnosed in 44 (78.6%), follicular carcinomas in 7 (12.5%), and 5 (8.9%) with medullary and anaplastic carcinomas. 12 (21.4%) were males and 44 (78.6%) were females. 20 (35.7%) were <40 years, 29 (51.8%) were between 40 and 59 years and 7 (12.5%) were above 59 years. Cross tabulation of type of carcinoma with gender revealed likelihood ratio of 6.908, significance P=0.032. Biochemically 12 (21.4%) were hyperthyroid. Out of them 5 (41.7%) had primary hyperthyroidism and 7 (58.3%) had secondary hyperthyroidism. Mean age of euthyroid patients was 43.77 years (S.D. 10.574) and hyperthyroid patients was 53.25 years (S.D. 16.057). Independent samples t-test is −2.446, two tailed significance P=0.018. When cross tabulate thyroid status with age group likelihood ratio was 9.640, significance P=0.008.

Conclusion: Papillary carcinoma is seen more among females. Among the patients with thyroid carcinomas, those with biochemically proven hyperthyroidism were more among the older age group than those who were euthyroid. Hence, careful evaluation of elderly hyperthyroid patients to select the most suitable therapeutic approach is justified.