Patients with medullary thyroid carcinoma
have a small papillary thyroid carcinoma more often than patients
with other thyroid disorders
(March 2005)
The background of the study. Small papillary carcinomas
(microcarcinomas) of the thyroid are found in not only otherwise
normal thyroid glands but also in multinodular goiters, the thyroid
glands of patients with Graves’ disease, and thyroid glands
with other tumors, including medullary carcinomas. This study determined
the frequency and characteristics of papillary carcinoma in patients
with medullary carcinoma and other thyroid disorders.
How the study was done. The study subjects were
196 patients with medullary carcinoma of the thyroid, 1657 patients
with multinodular goiter, and 311 patients with hyperthyroidism
caused by Graves’ disease who had undergone thyroidectomy.
The microscopic sections of their thyroid glands were reviewed.
The results of the study. Twenty-seven of the
196 patients (14 percent) with medullary carcinoma had a coincidental
papillary carcinoma. The papillary carcinomas were ≤1 cm in
21 patients. The two tumors were distinct in all the patients, and
they were in different lobes of the thyroid in 21 patients (78 percent).
Papillary carcinomas were found in the thyroid in 106 of the 1657
patients with a multinodular goiter (6 percent) and 16 of the 311
patients with Graves’ hyperthyroidism (5 percent).
The conclusions of the study. Patients with medullary
thyroid carcinoma have a coincidental papillary thyroid carcinoma
more often that do patients with a multinodular goiter or Graves’
disease.
The original article. Biscolla RP, Ugolini C,
Sculli M, Bottici V, Castagna MG, Romei C, Cosci B, Molinaro E,
Faviana P, Basolo F, Miccoli P, Pacini F, Pinchera A, Elisei R.
Medullary and papillary tumors are frequently associated in the
same thyroid gland without evidence of reciprocal influence in their
biologic behavior. Thyroid 2004;14:946-52.
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