Differentiated thyroid cancer in acromegaly: increased risk, unaltered outcomes

Tan Oksuz Sinem Başak; Aydemir Esra Eraslan; Aksu Ozge Baş; Rıfat Emral; Sevim Gullu

doi:10.1530/endoabs.110.P1137

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Endocrine Abstracts (2025) 110 P1137 | DOI: 10.1530/endoabs.110.P1137

ECEESPE2025 Poster Presentations Thyroid (141 abstracts)

Differentiated thyroid cancer in acromegaly: increased risk, unaltered outcomes

Sinem Başak Tan Öksüz ¹ , Esra Eraslan Aydemir ¹ , Özge Baş Aksu ¹ , Rıfat Emral ¹ & Sevim Güllü ¹

Author affiliations

¹Ankara University, Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Türkiye

JOINT1230

Introduction: Acromegaly is associated with an increased risk of cancer compared to the general population. Differentiated thyroid cancer (DTC) has been reported to be the most common type of malignancy in acromegaly. Whether DTC in patients with acromegaly are more aggressive is controversial.

Methods: The data of 14 acromegaly patients diagnosed with DTC and 42 non-acromegaly patients with DTC matched for age and sex (1:3) were retrospectively analyzed.

Results: In a cohort of 184 patients diagnosed with acromegaly, DTC was diagnosed in 14 (7.6%) patients. The mean age at DTC diagnosis was 49 ± 6.12 years. The median time from diagnosis of acromegaly to DTC was 36 months (IQR: 8.25 - 71.75). Two patients were diagnosed with PTC 12 months and 44 months before diagnosis of acromegaly, respectively. Five (37%) of the patients with acromegaly have active disease at the time of DTC diagnosis, 7 (50%) of them was in remission. Regarding the histological subtypes, 7 (50%) of them were classical subtypes, 6 (43%) of them were follicular subtypes and one (7%) of them was an oncocytic subtype Comparison of pathological and clinical features of acromegaly patients with DTC and non-acromegaly patients with DTC is summarized in table 1.

Table 1: Comparison of pathological and clinical features of acromegaly patients with DTC and non-acromegaly patients.
Parameter	DTC with acromegaly (n = 14)	Control group (n = 42)	P value
Tumor diameter (mm)	12.5 (IQR: 4.50 – 27.25)	7.0 (IQR: 4.75 – 11.25)	0.122
Multifocality (n, %)	5 (%35)	18 (%43)	0.638
Extracapsular invasion (n, %)	6 (%42)	7 (%17)	0.054
Lymph node metastasis (n, %)	2 (%14)	13 (%31)	0.223
Stage (n, %) -Stage 1 -Stage 2	13 (%93) 1 (%7)	40 (%95) 2 (%5)	0.732
RAI (n, %)	7 (%50)	18 (%43)	0.642
Total RAI dose (mCİ)	100 (IQR: 100 – 100)	100 (IQR: 75 – 131.25)	0.986
Response (n, %) -Excellent response -Biochemical incomplete response -Structural incomplete response	13 (93%) 1 (7%) 0 (%)	36 (%86) 3 (%7) 3 (%7)	0.588

Conclusion: The incidence of thyroid cancer is increased in patients with acromegaly when compared to the general population. This phenomenon may be attributed to enhanced awareness, screening, and early detection bias. Our study concluded that patients with acromegaly did not demonstrate a more aggressive course. A longer follow-up period and the inclusion of a higher number of DTC patients may support the long-term validity of the present data.