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

Autor: Cabezón CA; Endocrinology, Metabolism and Nuclear Medicine Service, Hospital Italiano de Buenos Aires, Argentina., Carrizo LC, Costanzo PR
Jazyk: angličtina
Zdroj: Arquivos brasileiros de endocrinologia e metabologia [Arq Bras Endocrinol Metabol] 2013 Jun; Vol. 57 (4), pp. 307-11.
DOI: 10.1590/s0004-27302013000400005
Abstrakt: 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.
Databáze: MEDLINE
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