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Amaç: Toksik nodüler (TNG) ve toksik multinodüler guatr (TMNG), bir veya birden fazla otonomfonksiyone tiroid nodülünün varlığı ile karakterize hipertiroidiye yol açan hastalıklardır. Hipertiroidinintiroid kanserine karşı koruyucu olduğu inancına karşın son yıllarda bu hastalarda da tiroid kanserriskinin azımsanmayacak kadar olduğu ve nodüllerin diğer hastalarda olduğu gibi değerlendirilmesigerektiği yönünde yayınlar çoğalmaktadır. Bu çalışmanın amacı TNG/TMNG nedeniyle cerrahiuygulanan hastalarda tiroid kanser sıklığını belirlemek ve kanser ile ilişkili olabilecek preoperatifözellikleri değerlendirmektir.Materyal ve Metot: Çalışmaya Ocak 2017 ile Aralık 2014 arasında TNG veya TMNG nedeniyletiroidektomi yapılan hastalar alınmıştır. Retrospektif olarak taranan hastaların klinik özellikleri,laboratuar ve ultrasonografi (US) sonuçları, sitolojik ve histopatolojik bulguları kayıt edilmiştir.Histopatolojik sonucu benign ve malign saptanan hastaların klinik özellikleri, nodüllerin preoperatif USözellikleri ve sitolojik sonuçları karşılaştırılmıştır.Bulgular: Çalışmaya alınan 482 hastanın 335’i (%69,50) kadın, 147’si (%30,50) erkekti ve ortanca yaş 56(18‐79) idi. 74 (%15,35) hastada TNG, 408 (%84,65) hastada TMNG vardı. Histopatolojik olarak 380(%78,84) hastada benign, 102 (%21,16) hastada malign patoloji saptandı. Benign ve malign hastalarda yaş,cinsiyet dağılımı, antitiroid kullanımı, antikor pozitifliği, nodül sayısı açısından fark yoktu. Malignhastalarda ultrasonografik olarak parankimde tiroidit varlığı anlamlı şekilde yüksekti (%75,26 ve %87,24;p

Objectives: Increased thyrotrophin receptor antibody (TRAb) was associated with thyroid cancer risk and aggressivity in patients with Graves disease. This relation was not investigated in patients with toxic nodular goiter (TNG) and toxic multinodular goiter (TMNG). We aimed to evaluate association between TRAb and thyroid cancer in patients with TNG and TMNG. Materials and Methods: Patients who underwent thyroidectomy with a preoperative diagnosis of TNG and TMNG were reviewed retrospectively. Among 370 patients, TRAb was available in 191 TMNG and 30 TNG patients. Results: TRAb was positive in 24 (10.86%) of 221 patients with TNG/TMNG. Histopathological result was malignant in 71 (32.13%) and benign in 150 (67.87%) patients. TRAb was positive in 7 (9.86%) of 71 malignant and 17 (11.33%) of 150 benign patients (p=0.742). Age, sex, serum thyrotrophin, free triiodothyronine, free thyroxine, anti-thyroid peroxidase and anti-thyroglobulin positivity, and histological tumor type did not differ between patients with positive and negative TRAb (p=0.393, p=0.401, p=0.403, p=0.903, p=0.877, p=0.788, p=0.540, and p=0.357, respectively). There was papillary thyroid cancer (PTC) in 7 (29.17%) patients with positive TRAb and 57 (28.93%) patients with negative TRAb (p=0.357). The variant of PTC was classical in 5 (71.43%) patients with positive and 50 (87.72%) patients with negative TRAb (p=0.242). Conclusion: In this study, we showed that TRAb positivity did not increase the risk of malignancy in patients with TNG/TMNG. [ABSTRACT FROM AUTHOR]

Objectives: Toxic nodular goiter (TNG) and toxic multinodular goiter (TMNG) are characterized by the presence of one or more autonomously functinoning thyroid nodules that causes hyperthyroidism. In contrary to the previous thought that hyperthyroidism is protective against thyroid cancer, there is increasing evidence that the risk of thyroid cancer should not be underestimated in these patients and nodules should be assessed as being in other patients. We aimed to determine the prevalence of thyroid cancer in TNG/TMNG patients that underwent thyroidectomy and evaluate preoperative features that might be associated with cancer. Materials and Methods: Patients diagnosed with TNG or TMNG and operated between January 2017 and December 2014 were included. The patients were scanned retropectively and clinical features, laboratuary findings, ultrasonography (US) reports, cytological and histopathological results were recorded. Clinical features of patients with benign and malignant histopathology, and preoperative US features and cytological results of benign and malignant nodules were compared. Results: There were 482 patients of which 335 (69.50%) were female and 147 (30.50%) were male and the median age was 56 (18-79). Preoperative diagnosis was TNG in 74 (15.35%) and TMNG in 408 (84.65%) patients. Histopathologically, 380 (78.84%) had benign and 102 (21.16%) had malignant disease. There was no significant difference in age, sex distribution, antithyroid usage, antibody positivity and median nodule number in benign and malignant patients. Ultrasonographically presence of thyroiditis in parenchyma was higher in malignant compared to benign patients (87.24% vs 75.26%. p<0.001). Ratio of patients operated for cytological diagnosis was higher in malignant, while patients operated for giant nodule was higher in benign patients. Among 1263 nodules with preoperative US data, 1222 (96.75%) were benign, 41 (3.25%) were malignant histopathologically. Rate of hypoechogenity was significantly higher in malignant than benign nodules. Other US features were similar in two groups. Among nodules with preoperative scintigraphy results, 406 (71.99%) of benign and 19 (67.86%) of malignant nodules were hot (p=0.853). Conclusion: In this study, the incidence of thyroid cancer in TNG/TMNG patients who underwent surgery was too high to be ignored. Preoperative US features of benign and malignant nodules were similar in these patients. We recommend that nodules in patients with TNG/TMNG should be evaluated by fine needle aspiration biopsy according to the same indications as for other nodules and when surgery is planned; total or near total thyroidectomy can be preferred particularly in the presence of TMNG. [ABSTRACT FROM AUTHOR]