World Journal of Endocrine Surgery

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VOLUME 13 , ISSUE 1 ( January-April, 2021 ) > List of Articles

Original Article

Elevated Risk of Papillary Thyroid Cancer in Guatemalan Patients with Hashimoto Thyroiditis

Ana Mejia-Pineda, Marco Antonio Peñalonzo, Maria-Lorena Aguilera-Arevalo

Keywords : Cohort study, Guatemala, Hashimoto thyroiditis, Papillary thyroid cancer

Citation Information : Mejia-Pineda A, Peñalonzo MA, Aguilera-Arevalo M. Elevated Risk of Papillary Thyroid Cancer in Guatemalan Patients with Hashimoto Thyroiditis. World J Endoc Surg 2021; 13 (1):1-3.

DOI: 10.5005/jp-journals-10002-1316

License: CC BY-NC 4.0

Published Online: 20-11-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Aim and objective: The relationship between Hashimoto's thyroiditis (HT) and papillary thyroid cancer (PTC) regarding their concurrence and the effect of concurrent HT on the prognosis of PTC has been controversial. In Guatemala, there are no studies of the coexistence of PTC and HT. This study aimed to determine if the presence of HT increased de risk of PTC and to determine if the presence of HT decreases the aggressiveness of PTC. Materials and methods: Clinicopathological data were assessed in all patients (n = 381) with thyroid pathology operated by a single surgical team over a period of 1996 to 2014 in Guatemala City. Of these participants, 115 with histologically confirmed PTC, measures of tumor aggressiveness were compared between patients with PTC and HT and PTC without HT. Results: In our study population, 19% (73/381) of the patients presented HT. After adjusting for age, sex, and nodule size; patients with HT presented more coexisting PTC [OR 2.56 (1.35–4.87)] compared to patients without HT. In the subgroup of patients with PTC (n = 115), 23% (26/115) had to coexist HT. Nodule size, angiovascular invasion, capsular invasion, lymph node metastasis, and extrathyroidal tissue invasion did not differ between patients with PTC with and without HT. Conclusion: The presence of HT in Guatemalan patients increases the risk of PTC, and the presence of HT does not decrease the aggressiveness of PTC. Clinical significance: High prevalence of PTC in patients with HT requires close clinical monitoring of patients.

  1. Harach HR, Escalante DA, Saravia E. Thyroid cancer and thyroiditis in Salta, Argentina: a 40-yr study in relation to iodine prophylaxis. Endocr Pathol 2002;13(3):175–181. DOI: 10.1385/EP:13:3:175.
  2. Gordin A, Maatela J, Miettinen A, et al. Serum thyrotrophin and circulating thyroglobulin and thyroid microsomal antibodies in a Finnish population. Acta Endocrinol (Copenh) 1979;90(1):33–42. DOI: 10.1530/acta.0.0900033Available at: Accessed May 31, 2014.
  3. Tunbridge WMG, Evered DC, Hall R, et al. The spectrum of thyroid disease in a community: the Whickham survey. Clin Endocrinol (Oxf) 1977;7(6):481–493. DOI: 10.1111/j.1365-2265.1977.tb01340.x Available at: Accessed May 31, 2014.
  4. Zhang L, Li H, Ji Q, et al. The clinical features of papillary thyroid cancer in Hashimoto's thyroiditis patients from an area with a high prevalence of Hashimoto's disease. BMC Cancer 2012;12(1):610. DOI: 10.1186/1471-2407-12-610.
  5. Ahn D, Heo SJ, Park JH, et al. Clinical relationship between Hashimoto's thyroiditis and papillary thyroid cancer. Acta Oncol 2011;50(8):1228–1234. DOI: 10.3109/0284186X.2011.602109.
  6. Larson SD, Jackson LN, Riall TS, et al. Increased incidence of well-differentiated thyroid cancer associated with Hashimoto thyroiditis and the role of the PI3k/Akt pathway. J Am Coll Surg 2007;204(5):764–773.; discussion 773-5 10.1016/j.jamcollsurg.2006.12.037.
  7. Arif S, Blanes A, Diaz-Cano SJ. Hashimoto's thyroiditis shares features with early papillary thyroid carcinoma. Histopathology 2002;41(4):357–362. DOI: 10.1046/j.1365-2559.2002.01467.x Available at: Accessed May 18, 2014.
  8. Brown TR, Zhao G, Palmer KC, et al. Thyroid injury, autoantigen availability, and the initiation of autoimmune thyroiditis. Autoimmunity 1998;27(1):1–12. Available at: Accessed May 31, 2014.
  9. Ruwhof C, Drexhage HA. Iodine and thyroid autoimmune disease in animal models. Thyroid 2001;11(5):427–436. DOI: 10.1089/105072501300176381.
  10. Jeong JS, Kim HK, Lee C-R, et al. Coexistence of chronic lymphocytic thyroiditis with papillary thyroid carcinoma: clinical manifestation and prognostic outcome. J Korean Med Sci 2012;27(8):883–889. DOI: 10.3346/jkms.2012.27.8.883.
  11. Del Rio P, Cataldo S, Sommaruga L, et al. The association between papillary carcinoma and chronic lymphocytic thyroiditis: does it modify the prognosis of cancer? Minerva Endocrinol 2008;33(1):1–5. Available at: Accessed January 4, 2014.
  12. Alexandre L, Freixo A, Ribeiro DA. Thyroid papillary carcinoma associated to Hashimoto's thyroiditis. 2012;78(6):77–80. DOI: 10.5935/1808-8694.20120037.
  13. Dailey ME, Lindsay S, Skahen R. Relation of thyroid neoplasms to Hashimoto disease of the thyroid gland. AMA Arch Surg 1955;70(2):291–297. DOI: 10.1001/archsurg.1955.01270080137023 Available at: Accessed May 28, 2014.
  14. Harach HR, Ceballos GA. Thyroid cancer, thyroiditis and dietary iodine: a review based on the Salta, Argentina model. Endocr Pathol 2008;19(4):209–220. DOI: 10.1007/s12022-008-9038-y.
  15. Ahmed R, Al-Shaikh S, Akhtar M. Hashimoto thyroiditis: a century later. Adv Anat Pathol 2012;19(3):181–186. DOI: 10.1097/PAP.0b013e3182534868.
  16. Nikiforova MN, Caudill CM, Biddinger P, et al. Prevalence of RET/PTC rearrangements in Hashimoto's thyroiditis and papillary thyroid carcinomas. Int J Surg Pathol 2002;10(1):15–22. DOI: 10.1177/106689690201000104 Available at: Accessed May 30, 2014.
  17. Lee J, Kim Y, Choi J, et al. The association between papillary thyroid carcinoma and histologically proven Hashimoto's thyroiditis: a meta-analysis. Eur J Endocrinol 2013;168(3):343–349. DOI: 10.1530/EJE-12-0903.
  18. McLeod MK, East ME, Burney RE, et al. Hashimoto's thyroiditis revisited: the association with thyroid cancer remains obscure. World J Surg 1988;12(4):509–516. DOI: 10.1007/BF01655435 Available at: Accessed May 18, 2014.
  19. Kebebew E, Treseler PA, Ituarte PH, et al. Coexisting chronic lymphocytic thyroiditis and papillary thyroid cancer revisited. World J Surg 2001;25(5):632–637. DOI: 10.1007/s002680020165.
  20. Lun Y, Wu X, Xia Q, et al. Hashimoto's thyroiditis as a risk factor of papillary thyroid cancer may improve cancer prognosis. Otolaryngol Head Neck Surg 2013;148(3). DOI: 10.1177/0194599812472426.
  21. Kim EY, Kim WG, Kim WB, et al. Coexistence of chronic lymphocytic thyroiditis is associated with lower recurrence rates in patients with papillary thyroid carcinoma. Clin Endocrinol (Oxf) 2009;71(4):581–586. DOI: 10.1111/j.1365-2265.2009.03537.x.
  22. Jara SM, Carson Ka, Pai SI, et al. The relationship between chronic lymphocytic thyroiditis and central neck lymph node metastasis in North American patients with papillary thyroid carcinoma. Surgery 2013;154(6):1272–1280.; discussion 1280-2 10.1016/j.surg.2013.07.021.
  23. Paulson LM, Shindo ML, Schuff KG. Role of chronic lymphocytic thyroiditis in central node metastasis of papillary thyroid carcinoma. Otolaryngol Head Neck Surg 2012;147(3):444–449. DOI: 10.1177/0194599812445727.
  24. Mazokopakis E, Tzortzinis A, Dalieraki-Ott E, et al. Coexistence of Hashimoto's thyroiditis with papillary thyroid carcinoma. A retrospective study. Hormones 2010;9(4):312–317. DOI: 10.14310/horm.2002.1282.
  25. Giordano C, Stassi G, De Maria R, et al. Potential involvement of FAS and its ligand in the pathogenesis of Hashimoto's thyroiditis. Science 1997;275(5302):960–963. DOI: 10.1126/science.275.5302.960 Available at: Accessed May 31, 2014.
  26. Kimura H, Yamashita S, Namba H, et al. Interleukin-1 inhibits human thyroid carcinoma cell growth. J Clin Endocrinol Metab 1992;75(2):596–602. DOI: 10.1210/jcem.75.2.1322431.
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