Thyroid Research Thyroid Research Archive Thyroid Cancer

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.