Evaluation of the Relationship Between Thyroid Nodules and Disease Activity in Patients with Acromegaly

Abstract

Introduction: Development of thyroid nodules is common in acromegaly patients. However data related with the clinical course of these nodules is rare in literature. We aimed to evaluate the relationship between thyroid nodules and disease activity in acromegaly patients.
Material and Methods: Presence of nodular thyroid disease, papillary thyroid cancer and parameters related with nodule development were investigated in a total of 138 acromegaly patients (F:73, M:65). In patients who were being followed up during the study period (n:56), thyroid ultrasonography was performed by an experienced radiologist and changes in nodule size (Group -1: decrease by >20%, Group-2: stationary with 0-20% change, Group-3 increase by >20%) was compared with disease activity.
Results: Frequency of thyroid nodules was %69 (n=95; 20 solitary nodul/75 multiple nodules), FNAB biopsy (n:55) revealed 66% benign, 16% suspicious, 11% malign and 7% nondiagnostic cytological results. Patients with thyroid nodules were older (p=0.05), had higher baseline IGF-1 % ULN (upper limit of normal) levels (p=0.01) and colon polyps were more frequent (p=0.017) (Table 1). Nodul size was stationary, decreased or increased in 45%, 30% and 25% of the patients, respectively. Presence of disease activity was significantly higher in patients with increased nodul size (p<0.0001) (Table 2).
Conclusion: Tyroid nodules are correlated with age and baseline IGF-1 levels in acromegaly patients. Thyroid nodules should be monitored regularly in patients with active acromegaly.