Associated thyroid disorders

A history of benign thyroid diseases has also been associated with a higher risk of thyroid cancers [1.37-1.40]. The relative risk (RR) is 6-10 times for goitre, 13-33 for adenomas, 2.8-4.4 for thyroiditis. Patients with autoimmune thyroiditis are considered to be at high risk (80 times) for developing malignant lymphoma of the thyroid as compared to controls [1.39].

No significant risk has been reported for hypothyroidism.

Risk stratification has been higher in women younger than 55 years for benign and malignant thyroid disorders, being 16 for adenoma and 7 for goitre. Benign thyroid disorders are less

th

Thyroid cancer is found in 5-8.7% of Graves’ disease [1.41-1.44]. Analogous to TSH as a growth factor for thyroid cancer, thyroid stimulating immunoglobulins are believed to promote the growth of thyroid cancer [1.44]. Therapy with antithyroid drugs or radioiodine does not per se predispose to development of thyroid cancer. Cancer coexisting with Graves’

disease is reported by some to be aggressive while others find no difference in the biological behaviour of the two diseases. These differences have been attributed to selection bias, geographical location (iodine deficiency) [1.40], genetic predisposition [1.45, 1.46] and environmental factors such as exposure to radiation in early childhood. Recently, Hayes, et al.

has described four cases with toxic nodular goitre and thyroid cancer having an aggressive course of disease [1.42].

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