Evolution of differentiated thyroid cancer during pregnancy in a community University Hospital in Buenos Aires, Argentina

CA Cabezón, LC Carrizo, PR Costanzo - Arquivos Brasileiros de …, 2013 - SciELO Brasil
CA Cabezón, LC Carrizo, PR Costanzo
Arquivos Brasileiros de Endocrinologia & Metabologia, 2013SciELO Brasil
OBJECTIVE: To analyze the presentation, follow-up and evolution of differentiated thyroid
cancer (DTC) detected during pregnancy. SUBJECTS AND METHODS: Twenty nine women
with DTC detected during pregnancy were analyzed. Group I (n= 13) was seen during
pregnancy and DTC was diagnosed during gestation; detection of the nodule occurred
during pregnancy (first trimester). Group II (n= 16) was seen after delivery; detection of the
nodule occurred during pregnancy (second or third trimester). Complete thyroidectomy …
OBJECTIVE
To analyze the presentation, follow-up and evolution of differentiated thyroid cancer (DTC) detected during pregnancy.
SUBJECTS AND METHODS
Twenty nine women with DTC detected during pregnancy were analyzed. Group I (n = 13) was seen during pregnancy and DTC was diagnosed during gestation; detection of the nodule occurred during pregnancy (first trimester). Group II (n = 16) was seen after delivery; detection of the nodule occurred during pregnancy (second or third trimester). Complete thyroidectomy, ablative dose of radioactive iodine, and treatment with levothyroxine were performed. Follow-up: neck ultrasound; TSH, free T4, thyroglobulin, and anti-thyroglobulin antibodies with and without treatment with levothyroxine; and 131I whole body scans. Histological diagnosis, lymph node metastases, tumor size and stage, complications from pregnancy, and DTC evolution were evaluated.
RESULTS
100% of the patients had papillary thyroid carcinoma. Lymph node metastases were detected in 13 (44.8%), and invasion of adjacent extrathyroid tissue in 2 patients. Tumor size was larger in Group II: 22.1 ± 10.9 versus 13.9 ± 3.5 mm; p = 0.03. No differences were found in the tumor stages between groups. All patients had full-term pregnancies and healthy newborns. Follow-up: 5.7 ± 4.3 years; one patient had persistent disease.
CONCLUSIONS
DTC detected during pregnancy had a favorable evolution. Surgery may be postponed to the post-delivery period, unless there are risk factors that justify it during pregnancy.
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