Navegando por Palavras-chave "Neoplasias Da Glândula Tireoide"

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    Desfecho clínico de carcinoma de tiroide associado à Doença de Graves: experiência de centro de referência brasileiro
    (Universidade Federal de São Paulo (UNIFESP), 2019-05-30) Santos, Thayana Linhares [UNIFESP]; Maciel, Rui Monteiro De Barros [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introduction: The incidence of thyroid nodules, as well as differentiated thyroid carcinoma (DTC), is higher in patients with Graves’ disease (GD) than in those with normal thyroid function. Some studies have shown that DTC diagnosed in patients with a history of GD has a more aggressive behavior at diagnosis. However, the studies are old and do not include initial risk stratification and response to treatment. Moreover, there is no data related to GD prevalence in a DTC brazilian population followed in reference center. Purpose: Evaluate the GD prevalence in CDT patients, the risk of recurrence and the outcome of DTC patients with previous or concomitant history of GD. Methods: It is about a retrospective observational study, with collected information from electronic and physical medical records in a lapse from 1982 to 2017, focused on DTC/GD patients who have been assisted at the Thyroid Outpatient Clinic of the Discipline of Endocrinology of the Federal University of São Paulo / Paulista Medicine School, São Paulo, Brazil. The risk of recurrence of CDT and response to treatment was determined according to guidelines established by the American Thyroid Association (ATA). Results: From 601 DTC patients, 24 (3,9%) presented previous history of GD, 23 women and 1 man, with a mean age of 41.8 ± 12 years (range: 22-69). Eight patients had TRAb dosage, with only two of them with positive value. Regarding the clinical situation of the diagnosis of DTC, only one case (4%) was incidental and 23 (96%) were clinically suspect patients. Papillary carcinoma was the histological finding in all patients, with 50% classical variant, 46% follicular variant and 4% diffuse sclerosing variant, and two cases presented concomitant xiv follicular and classic variants. Regarding the risk of recurrence, according to the ATA, 58% (14) were classified as low risk of recurrence, 38% (9) intermediate risk and 4% (1) high risk. All patients were treated with total thyroidectomy and 79% with radioactive iodine (mean activity administered: 170 mCi, range: 30-440 mCi). Regarding the response to treatment, 92% (22) presented excellent response and 8% (2) presented structural disease. Conclusion: The prevalence of GD in patients followed by DTC at a Brazilian reference center was 3.9%. The majority of cases (92%) presented excellent response to treatment. Only 8% of the patients presented structural disease and these patients presented a higher risk of recurrence to the DTC diagnosis.