Clinical Assessment and Management of Papillary Thyroid Carcinoma with Coexistent Hashimoto's Thyroiditis

Shim, Youn Sang; Lee, Yong Sik; Lee, Guk Haeng; Lee, Byeong Cheol; Jung, Yeon Woo; Lee, Ji Woong; Yi, Ka Hee; Lee, Yun Yong; Lee, Seung Sook

Abstract

BACKGROUND AND OBJECTIVES: The frequency of co-occurence of Hashimoto's thyroiditis and papillary thyroid carcinoma has been variously reported to range from 0.3% to 38%, and the association of these two diseases is still controversial. The aim of our study is to determine the relationship between these two entities, and in this paper, we compare the clinical characteristics of patients with and without histopathological evidence of Hashimoto's thyroiditis.
SUBJECTS AND METHOD
Among 366 patients treated for thyroid nodules (including benign nodules and thyroid cancers) during the period of July 2004-June 2005, 278 patients (male versus female=1 : 7.9) with papillary thyroid carcinoma were included in this study.
RESULTS
Hashimoto's thyroiditis co-occurred with papillary thyroid carcinoma in 68 of 278 patients (24.5%), compared with 0 of 21 patients (0%) with other thyroid malignancies. The age at presentation (median, 43.9 years), tumor size (median, 1.31 cm), methods of diagnostic evaluation, and the extent of surgery had not influenced by the presence of Hashimoto's thyroiditis. However, TNM stage, AMES stage, MACIS score were slightly lower and the proportion of female patients (1 : 67) was higher in patients with Hashimoto's thyroiditis.
CONCLUSION
These results suggest that patients who have papillary thyroid carcinoma may have more favorable prognosis in the co-ocurring Hashimoto's thyroiditis. Further studies are required to confirm the long-term prognostic association between these two diseases.