Endocrinology Research and Practice
Original Article

Nodular Thyroid Disease and Papillary Thyroid Carcinoma in Functional Pituitary Adenomas

1.

İstanbul University İstanbul Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, İstanbul, Turkey

Endocrinol Res Pract 2018; 22: 158-166
DOI: 10.25179/tjem.2018-60237
Read: 2409 Downloads: 706 Published: 01 September 2018

ABSTRACT

Objective: Increased frequency of nodular thyroid disease has been reported in acromegalic patients. Recent studies have also demonstrated an increased co-existence of nodular thyroid di- sease with Cushing’s disease and prolactinoma. In this study, we evaluated the frequency and outcomes of nodular thyroid disease in each type of functional pituitary adenoma.

Material and Methods: A total of 232 patients diagnosed with acromegaly (n=138), prolactinoma (n=59) or Cushing’s disease (n=35) were included in this retrospective observational study. The frequency of nodular thyroid disease, fine-needle aspiration re- sults, and the frequency of papillary thyroid carcinoma were com- pared in each group. Factors related to nodule development were evaluated in functional pituitary adenoma patients with or without nodules.

Results: Nodular thyroid disease frequency was higher in pati- ents with acromegaly (69%) compared to those with prolactinoma (36%) or Cushing’s disease (34%) (p<0.001). Fine-needle aspi- ration results and PTC frequencies were similar between the gro- ups. In comparison to patients without nodules (n=104), those with nodules (n=128) were older (p=0.01) and had a higher inci- dence of glucose metabolism disorders (p=0.006). Insulin-like growth factor-1 levels were higher in acromegalic patients with no- dular thyroid disease (p=0.01). There was no relationship between nodule formation and baseline prolactin or cortisol/adrenocorticot- ropic hormone levels in the patients with prolactinomas and Cus- hing’s disease, respectively.

Conclusion: Although nodular thyroid disease was more common in acromegalic patients, its incidence in patients with prolactinoma and Cushing’s disease were higher than previously reported in our country (23.5%). The most important factors affecting nodule for- mation in functional pituitary adenoma patients were glucose me- tabolism disorders and age. Although a higher frequency of PTC has been reported in acromegalic patients, it was similar for all functional pituitary adenoma patients in our study.

 

 

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