CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2021; 25(02): e219-e223
DOI: 10.1055/s-0040-1710307
Original Research

Association between Thyroiditis and Multifocality in Papillary Thyroid Carcinoma

1   Department of Surgery, Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil
2   Department of Head and Neck Surgery, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil
,
1   Department of Surgery, Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil
3   Department of Head and Neck Surgery, Instituto do Câncer do Estado de São Paulo (Icesp), São Paulo, São Paulo, Brazil
,
4   Department of Head and Neck Surgery, Hospital Ana Costa, Santos, São Paulo, Brazil
,
4   Department of Head and Neck Surgery, Hospital Ana Costa, Santos, São Paulo, Brazil
› Author Affiliations

Abstract

Introduction Hashimoto thyroiditis (HT) shares many characteristics with papillary thyroid carcinoma (PTC), and some studies show that, when associated, PTC is diagnosed mostly with smaller lesions and multifocal pattern.

Objective To evaluate the relationship between HT and PTC.

Methods A retrospective study of 155 patients who underwent total thyroidectomy from 2009 to 2015. Demographical, clinical and ultrasonographical data, as well as anatomopathological findings were evaluated.

Results There were signs of thyroidits in 35 patients, and 114 patients had a unifocal disease. There was no statistical significance between the variables studied and thyroiditis. However, when compared with the occurrence of unifocal or multifocal lesions, there was statistical significance regarding age (p = 0.038) and mass (p = 0.031). There was no direct relationship between thyroiditis and multifocality (p = 0.325) nor between thyroiditis and cervical extension of the disease (p = 0.300 e p = 0.434).

Conclusion There was no relationship between thyroiditis and multifocality in cases of PTC.



Publication History

Received: 13 October 2019

Accepted: 12 March 2020

Article published online:
23 June 2020

© 2020. Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Mazokopakis EE, Tzortzinis AA, Dalieraki-Ott EI. et al. Coexistence of Hashimoto's thyroiditis with papillary thyroid carcinoma. A retrospective study. Hormones (Athens) 2010; 9 (04) 312-317
  • 2 Jankovic B, Le KT, Hershman JM. Clinical Review: Hashimoto's thyroiditis and papillary thyroid carcinoma: is there a correlation?. J Clin Endocrinol Metab 2013; 98 (02) 474-482
  • 3 Ahn D, Heo SJ, Park JH. et al. Clinical relationship between Hashimoto's thyroiditis and papillary thyroid cancer. Acta Oncol 2011; 50 (08) 1228-1234
  • 4 Zhu F, Shen YB, Li FQ, Fang Y, Hu L, Wu YJ. The effects of Hashimoto thyroiditis on lymph node metastases in unifocal and multifocal papillary thyroid carcinoma: A retrospective Chinese cohort study. Medicine (Baltimore) 2016; 95 (06) e2674
  • 5 Repplinger D, Bargren A, Zhang YW, Adler JT, Haymart M, Chen H. Is Hashimoto's thyroiditis a risk factor for papillary thyroid cancer?. J Surg Res 2008; 150 (01) 49-52
  • 6 Dailey ME, Lindsay S, Skahen R. Relation of thyroid neoplasms to Hashimoto disease of the thyroid gland. AMA Arch Surg 1955; 70 (02) 291-297
  • 7 Lee JH, Kim Y, Choi JW, Kim YS. The association between papillary thyroid carcinoma and histologically proven Hashimoto's thyroiditis: a meta-analysis. Eur J Endocrinol 2013; 168 (03) 343-349
  • 8 Konturek A, Barczyński M, Nowak W, Wierzchowski W. Risk of lymph node metastases in multifocal papillary thyroid cancer associated with Hashimoto's thyroiditis. Langenbecks Arch Surg 2014; 399 (02) 229-236
  • 9 Cipolla C, Sandonato L, Graceffa G. et al. Hashimoto thyroiditis coexistent with papillary thyroid carcinoma. Am Surg 2005; 71 (10) 874-878
  • 10 Arif S, Blanes A, Diaz-Cano SJ. Hashimoto's thyroiditis shares features with early papillary thyroid carcinoma. Histopathology 2002; 41 (04) 357-362
  • 11 Royer MC, Zhang H, Fan CY, Kokoska MS. Genetic alterations in papillary thyroid carcinoma and hashimoto thyroiditis: An analysis of hOGG1 loss of heterozygosity. Arch Otolaryngol Head Neck Surg 2010; 136 (03) 240-242
  • 12 Cordioli MI, Cury AN, Nascimento AO, Oliveira AK, Mello M, Saieg MA. Study of the histological profile of papillary thyroid carcinomas associated with Hashimoto's thyroiditis. Arq Bras Endocrinol Metabol 2013; 57 (06) 445-449
  • 13 Azizi G, Keller JM, Lewis M. et al. Association of Hashimoto's thyroiditis with thyroid cancer. Endocr Relat Cancer 2014; 21 (06) 845-852
  • 14 Latrofa F, Ricci D, Montanelli L. et al. Lymphocytic thyroiditis on histology correlates with serum thyroglobulin autoantibodies in patients with papillary thyroid carcinoma: impact on detection of serum thyroglobulin. J Clin Endocrinol Metab 2012; 97 (07) 2380-2387
  • 15 Kurukahvecioglu O, Taneri F, Yüksel O, Aydin A, Tezel E, Onuk E. Total thyroidectomy for the treatment of Hashimoto's thyroiditis coexisting with papillary thyroid carcinoma. Adv Ther 2007; 24 (03) 510-516
  • 16 Bradly DP, Reddy V, Prinz RA, Gattuso P. Incidental papillary carcinoma in patients treated surgically for benign thyroid diseases. Surgery 2009; 146 (06) 1099-1104
  • 17 Nguyen GK, Ginsberg J, Crockford PM, Villanueva RR. Hashimoto's thyroiditis: cytodiagnostic accuracy and pitfalls. Diagn Cytopathol 1997; 16 (06) 531-536
  • 18 Ravinsky E, Safneck JR. Differentiation of Hashimoto's thyroiditis from thyroid neoplasms in fine needle aspirates. Acta Cytol 1988; 32 (06) 854-861
  • 19 Kumarasinghe MP, De Silva S. Pitfalls in cytological diagnosis of autoimmune thyroiditis. Pathology 1999; 31 (01) 1-7
  • 20 MacDonald L, Yazdi HM. Fine needle aspiration biopsy of Hashimoto's thyroiditis. Sources of diagnostic error. Acta Cytol 1999; 43 (03) 400-406
  • 21 Seifman MA, Grodski SF, Bailey M, Yeung MJ, Serpell JW. Surgery in the setting of Hashimoto's thyroiditis. ANZ J Surg 2011; 81 (7-8): 519-523
  • 22 Singh B, Shaha AR, Trivedi H, Carew JF, Poluri A, Shah JP. Coexistent Hashimoto's thyroiditis with papillary thyroid carcinoma: impact on presentation, management, and outcome. Surgery 1999; 126 (06) 1070-1076 , discussion 1076–1077
  • 23 Gul K, Dirikoc A, Kiyak G. et al. The association between thyroid carcinoma and Hashimoto's thyroiditis: the ultrasonographic and histopathologic characteristics of malignant nodules. Thyroid 2010; 20 (08) 873-878
  • 24 Muzza M, Degl'Innocenti D, Colombo C. et al. The tight relationship between papillary thyroid cancer, autoimmunity and inflammation: clinical and molecular studies. Clin Endocrinol (Oxf) 2010; 72 (05) 702-708
  • 25 Matsubayashi S, Kawai K, Matsumoto Y. et al. The correlation between papillary thyroid carcinoma and lymphocytic infiltration in the thyroid gland. J Clin Endocrinol Metab 1995; 80 (12) 3421-3424
  • 26 Gupta S, Patel A, Folstad A. et al. Infiltration of differentiated thyroid carcinoma by proliferating lymphocytes is associated with improved disease-free survival for children and young adults. J Clin Endocrinol Metab 2001; 86 (03) 1346-1354
  • 27 Del Rio P, Cataldo S, Sommaruga L, Concione L, Arcuri MF, Sianesi M. The association between papillary carcinoma and chronic lymphocytic thyroiditis: does it modify the prognosis of cancer?. Minerva Endocrinol 2008; 33 (01) 1-5
  • 28 Wang F, Yu X, Shen X. et al. The prognostic value of tumor multifocality in clinical outcomes of papillary thyroid cancer. J Clin Endocrinol Metab 2017; 102 (09) 3241-3250
  • 29 Kiriakopoulos A, Petralias A, Linos D. Multifocal versus solitary papillary thyroid carcinoma. World J Surg 2016; 40 (09) 2139-2143
  • 30 Kim KJ, Kim SM, Lee YS, Chung WY, Chang HS, Park CS. Prognostic significance of tumor multifocality in papillary thyroid carcinoma and its relationship with primary tumor size: a retrospective study of 2,309 consecutive patients. Ann Surg Oncol 2015; 22 (01) 125-131
  • 31 Leboulleux S, Rubino C, Baudin E. et al. Prognostic factors for persistent or recurrent disease of papillary thyroid carcinoma with neck lymph node metastases and/or tumor extension beyond the thyroid capsule at initial diagnosis. J Clin Endocrinol Metab 2005; 90 (10) 5723-5729
  • 32 Ross DS, Litofsky D, Ain KB. et al. Recurrence after treatment of micropapillary thyroid cancer. Thyroid 2009; 19 (10) 1043-1048
  • 33 Neuhold N, Schultheis A, Hermann M, Krotla G, Koperek O, Birner P. Incidental papillary microcarcinoma of the thyroid--further evidence of a very low malignant potential: a retrospective clinicopathological study with up to 30 years of follow-up. Ann Surg Oncol 2011; 18 (12) 3430-3436
  • 34 Zhao Q, Ming J, Liu C. et al. Multifocality and total tumor diameter predict central neck lymph node metastases in papillary thyroid microcarcinoma. Ann Surg Oncol 2013; 20 (03) 746-752
  • 35 Vasileiadis I, Karakostas E, Charitoudis G. et al. Papillary thyroid microcarcinoma: clinicopathological characteristics and implications for treatment in 276 patients. Eur J Clin Invest 2012; 42 (06) 657-664
  • 36 He Q, Zhuang D, Zheng L. et al. The surgical management of papillary thyroid microcarcinoma: a 162-month single-center experience of 273 cases. Am Surg 2012; 78 (11) 1215-1218
  • 37 Kim HJ, Sohn SY, Jang HW, Kim SW, Chung JH. Multifocality, but not bilaterality, is a predictor of disease recurrence/persistence of papillary thyroid carcinoma. World J Surg 2013; 37 (02) 376-384
  • 38 Lin JD, Chao TC, Hsueh C, Kuo SF. High recurrent rate of multicentric papillary thyroid carcinoma. Ann Surg Oncol 2009; 16 (09) 2609-2616
  • 39 Hay ID, Hutchinson ME, Gonzalez-Losada T. et al. Papillary thyroid microcarcinoma: a study of 900 cases observed in a 60-year period. Surgery 2008; 144 (06) 980-987 , discussion 987–988
  • 40 So YK, Son YI, Hong SD. et al. Subclinical lymph node metastasis in papillary thyroid microcarcinoma: a study of 551 resections. Surgery 2010; 148 (03) 526-531
  • 41 Ito Y, Miyauchi A. Lateral lymph node dissection guided by preoperative and intraoperative findings in differentiated thyroid carcinoma. World J Surg 2008; 32 (05) 729-739