Prevalence of thyroid cancer in familial adenomatous polyposis syndrome and the role of screening ultrasound examinations

被引:85
作者
Herraiz, Maite
Barbesino, Giuseppe
Faquin, William
Chan-Smutko, Gayun
Patel, Devanshi
Shannon, Kristen M.
Daniels, Gilbert H.
Chung, Daniel C.
机构
[1] Massachusetts Gen Hosp, Gastrointestinal Unit, Dept Med, Boston, MA 02114 USA
[2] Massachusetts Gen Hosp, Thyroid Unit, Dept Med, Boston, MA 02114 USA
[3] Massachusetts Gen Hosp, Dept Pathol, Boston, MA 02114 USA
[4] Massachusetts Gen Hosp, Ctr Canc Risk Anal, Boston, MA 02114 USA
关键词
D O I
10.1016/j.cgh.2006.10.019
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background & Aims: Thyroid carcinoma is an extraintestinal manifestation of familial adenomatous polyposis (FAP) syndrome, but the precise risk is unknown. The optimal approach for thyroid cancer screening has not been established. We sought to define the prevalence of thyroid cancer and the role of screening ultrasound in FAP patients. Methods: We performed a retrospective chart review of 51 patients with a proven diagnosis of FAP at a single tertiary institution. Clinical records, genetic test results, ultrasound examinations, and histopathology were reviewed. Results: Papillary thyroid cancer was diagnosed in 6 female patients (12%). The mean age of thyroid cancer diagnosis was 33 years, and mean tumor size was 12 turn. However, all patients had additional malignant foci that were small (1-9 mm), and none had suspicious features of malignancy on ultrasound. Of 28 patients who had at least one screening ultrasound, 22 (79%) had thyroid nodules, and 2 (7%) had papillary thyroid carcinoma. Of those with nodules, 68% had multinodular disease. A follow-up ultrasound in 12 patients after a mean of 15 months revealed no changes in either the number or size of nodules. Conclusions: The 12% prevalence of thyroid cancer in this series of FAP patients is significantly higher than in previous reports. Among patients undergoing screening ultrasound, 7% had thyroid cancer. Nodular thyroid disease is very common in FAP. Because small nodules (<9 mm) might also be malignant, close follow-up with ultrasound and fine-needle aspiration might be warranted.
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页码:367 / 373
页数:7
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