ketendoКлиническая и экспериментальная тиреоидологияClinical and experimental thyroidology1995-54722310-3787Endocrinology Research Centre10.14341/ket12723ketendo-12723Research ArticleКлинический случайCase ReportСочетание папиллярной микрокарциномы щитовидной железы и диффузного токсического зоба у пациента с акромегалиейThe combination of papillary thyroid microcarcinoma and diffuse toxic goiter in a patient with acromegalyhttps://orcid.org/0000-0002-0327-4619ДзерановаЛ. К.DzeranovaL. K.

Дзеранова Лариса Константиновна, д.м.н

eLibrary SPIN: 2958-555

Москва

 

Larisa K. Dzeranova, MD, Sc.D.

eLibrary SPIN: 2958-5555

Moscow

dzeranovalk@yandex.ruhttps://orcid.org/0000-0001-5917-6869ТкачукА. В.TkachukA. V.

Ткачук Арина Вадимовна

eLibrary SPIN: 8825-8874

Москва

Arina V. Tkachuk, MD

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Moscow

arinatarasova@inbox.ruhttps://orcid.org/0000-0001-6539-466XПигароваЕ. А.PigarovaE. A.

Пигарова Екатерина Александровна, д.м.н. 

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Москва

Ekaterina A. Pigarova, MD, PhD

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Moscow

kpigarova@gmail.comhttps://orcid.org/0000-0001-5824-6490ПерепеловаМ. А.PerepelovaM. A.

Перепелова Маргарита Александровна, клинический ординатор 

117036, Москва, ул. Дмитрия Ульянова, д. 11, к. 2 

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Margarita A. Perepelova, clinical resident

Dmitry Ulyanova street 11 bld 2, 117036 Moscow

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margo.doktor@mail.ruhttps://orcid.org/0000-0001-7552-259XКимИ. В.KimI. V.

Ким Илья Викторович, к.м.н.

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Москва

Ilya V. Kim, PhD

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Moscow

ilyakim@yandex.ruhttps://orcid.org/0000-0001-5724-6763ДоровскихА. В.DorovskikhA. V.

Доровских Анна Владимировна

Москва

 

Anna V. Dorovskikh, clinical resident

Moscow

 

a.v.dorovskikh@gmail.comhttps://orcid.org/0000-0003-0047-7223ШутоваА. С.ShutovaA. S.

Шутова Александра Сергеевна

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Москва

Aleksandra S. Shutova

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Moscow

shutova.aleksandra@gmail.comНациональный медицинский исследовательский центр эндокринологииEndocrinology research centre2022210720221812933Copyright © Дзеранова Л.К., Ткачук А.В., Пигарова Е.А., Перепелова М.А., Ким И.В., Доровских А.В., Шутова А.С., 20222022Дзеранова Л.К., Ткачук А.В., Пигарова Е.А., Перепелова М.А., Ким И.В., Доровских А.В., Шутова А.С.Dzeranova L.K., Tkachuk A.V., Pigarova E.A., Perepelova M.A., Kim I.V., Dorovskikh A.V., Shutova A.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.cet-endojournals.ru/jour/article/view/12723

Акромегалия — тяжелое мультифакториальное нейроэндокринное заболевание, сопровождающееся повышенной секрецией гормона роста, что способствует активной пролиферации клеток различных тканей в организме. Среди осложнений заболевания преобладает сердечно-сосудистая патология, которая нередко является причиной повышенной смертности. Однако в последнее время при акромегалии все чаще описываются случаи выявления рака щитовидной железы. Причины и рост распространенности доброкачественных и злокачественных новообразований щитовидной железы у пациентов с акромегалией вызывают многочисленные дебаты в медицинском мире. Рекомендации American Thyroid Association не включают акромегалию в список состояний с повышенным риском рака щитовидной железы, однако ряд экспериментальных и эпидемиологических данных указывает на высокую вероятность подобных осложнений.

Нами представлен клинический случай диагностированного папиллярного рака щитовидной железы и диффузного токсического зоба у пациентки с акромегалией.

Acromegaly is a severe multifactorial neuroendocrine disease accompanied by increased secretion of growth hormone, which contributes to the active proliferation of cells of various tissues in the body. Among the complications of the disease, cardiovascular pathology predominates, and is often the cause of increased mortality. Recently, however, with acromegaly, cases of detection of thyroid cancer are increasingly described. The causes and increasing prevalence of benign and malignant neoplasms of the thyroid gland in patients with acromegaly cause much debate in the medical world. The American Thyroid Association guidelines do not include acromegaly in the list of conditions with an increased risk of thyroid cancer but a number of experimental and epidemiological data indicate a high likelihood of such complications. We present a clinical case of diagnosed papillary thyroid cancer in a patient with acromegaly.

акромегалияпапиллярный рак щитовидной железыдиффузный зобинсулиноподобный фактор роста 1ИФР-1acromegalypapillary thyroid cancerdiffuse goiterinsulin-like growth factor-1IGF-1Исследование проведено при финансовой поддержке Министерства здравоохранения Российской Федерации в рамках выполнения государственного задания «Эпидемиологические и молекулярно-клеточные характеристики опухолевых, аутоиммунных и йододефицитных тиреопатий как основа профилактики осложнений и персонализированного лечения», № НИОКТР AAAA-A20-120011790180-4.ReferencesGasperi M, Martino E, Manetti L, et al. Prevalence of thyroid diseases in patients with acromegaly: results of an Italian Multi-center Study. J Endocrinol Invest. 2002;25(3):240-245. doi: https://doi.org/10.1007/BF03343997Gasperi m, martino e, manetti l, et al. Prevalence of thyroid diseases in patients with acromegaly: results of an italian multi-center study. J endocrinol invest. 2002;25(3):240-245. Doi:10.1007/bf03343997Tita P, Ambrosio MR, Scollo C, et al. High prevalence of differentiated thyroid carcinoma in acromegaly. Clin Endocrinol (Oxf ). 2005;63(2):161-167. doi: https://doi.org/10.1111/j.1365-2265.2005.02316.xTita p, ambrosio mr, scollo c, et al. High prevalence of differentiated thyroid carcinoma in acromegaly. Clin endocrinol (oxf). 2005;63(2):161-167. Doi:10.1111/j.1365-2265.2005.02316Uchoa HB de MP, Lima GAB, Corrêa LL, et al. Prevalence of thyroid diseases in patients with acromegaly: experience of a Brazilian center. Arq Bras Endocrinol Metabol. 2013;57(9):685-690. doi: https://doi.org/10.1590/S0004-27302013000900003Uchoa hb, lima ga, corrêa ll, et al. Prevalence of thyroid diseases in patients with acromegaly: experience of a brazilian center. Arq bras endocrinol metabol. 2013;57(9):685-690. Doi:10.1590/s0004-27302013000900003Cankurtaran Y, Örük GG, Tozduman B. Evaluation of thyroid disease and thyroid malignancy in acromegalic patients. Minerva Endocrinol. 2021;57(9):685-690. doi: https://doi.org/10.23736/S2724-6507.21.03363-7Cankurtaran y, örük gg, tozduman b. Evaluation of thyroid disease and thyroid malignancy in acromegalic patients [published online ahead of print, 2021 may 14]. Minerva endocrinol (torino). 2021;10.23736/s2724-6507.21.03363-7. Doi:10.23736/s2724-6507.21.03363-7Chen Y-K, Lin C-L, Chang Y-J, et al. Cancer Risk in Patients with Graves’ Disease: A Nationwide Cohort Study. Thyroid. 2013;23(7):879-884. doi: https://doi.org/10.1089/thy.2012.0568.Miyauchi a, ito y. Conservative surveillance management of low-risk papillary thyroid microcarcinoma. Endocrinol metab clin north am. 2019; 48(1):215-226. Https://doi.org/10.1016/j.ecl.2018.10.007Kwon H, Moon B-I. Prognosis of papillary thyroid cancer in patients with Graves’ disease: a propensity scorematched analysis. World J Surg Oncol. 2020;18(1):266. doi: https://doi.org/10.1186/s12957-020-02044-xLuo y, zhao y, chen k, et al. Clinical analysis of cervical lymph node metastasis risk factors in patients with papillary thyroid microcarcinoma. J endocrinol invest. 2019;42(2):227-236. Https://doi.org/10.1007/s40618-018-0908-yStaniforth JUL, Erdirimanne S, Eslick GD. Thyroid carcinoma in Graves’ disease: A meta-analysis. Int J Surg. 2016;27:118-125. doi: https://doi.org/10.1016/j.ijsu.2015.11.027Page c, biet a, boute p, et al. ‘aggressive papillary’ thyroid microcarcinoma. Eur arch oto-rhino-laryngol. 2009;266(12):1959-1963. Https://doi.org/10.1007/s00405-009-0952-5Medas F, Erdas E, Canu GL, et al. Does hyperthyroidism worsen prognosis of thyroid carcinoma? A retrospective analysis on 2820 consecutive thyroidectomies. J Otolaryngol - Head Neck Surg. 2018;47(1):6. doi: https://doi.org/10.1186/s40463-018-0254-2Yang l, tan z, li y, zhang x, wu y, xu b, wang m. Insulin-like growth factor 1 promotes proliferation and invasion of papillary thyroid cancer through the stat3 pathway. J clin lab anal. 2020 dec; 34(12):e23531. Doi: 10.1002/jcla.23531. Epub 2020 aug 26. Pmid: 32851683; pmcid: pmc7755808.Dias Lopes NM, Mendonça Lens HH, Armani A, Marinello PC, Cecchini AL. Thyroid cancer and thyroid autoimmune disease: A review of molecular aspects and clinical outcomes. Pathol - Res Pract. 2020;216(9):153098. doi: https://doi.org/10.1016/j.prp.2020.153098;Pidchenko ns, krasnoselskyi mv, mitriaieva na, grebenik lv, astapieva om, grushka gv, paskevych oi, fedulenkova yy, myroshnychenk ms. Insulin-like growth factors in the serum of patients with papillary thyroid cancer. Wiad lek. 2021; 74 (8):1925-1930. Pmid: 34537745.Yoshioka W, Miyauchi A, Ito M, et al. Kinetic analyses of changes in serum TSH receptor antibody values after total thyroidectomy in patients with Graves disease. Endocr J. 2016;63(2):179-185. doi: https://doi.org/10.1507/endocrj.EJ15-0492Lawnicka h, motylewska e, borkowska m, kuzdak k, siejka a, swietoslawski j, stepien h, stepien t. Elevated serum concentrations of igf-1 and igf-1r in patients with thyroid cancers. Biomed pap med fac univ palacky olomouc czech repub. 2020 mar; 164 (1):77-83. Doi: 10.5507/bp.2019.018. Epub 2019 may 23. Pmid: 31132076.Miyauchi A, Ito Y. Conservative Surveillance Management of Low-Risk Papillary Thyroid Microcarcinoma. Endocrinol Metab Clin North Am. 2019;48(1):215-226. doi: https://doi.org/10.1016/j.ecl.2018.10.007Chen YK, Lin CL, Chang YJ, Cheng FT, Peng CL, Sung FC, et al. Cancer risk in patients with Graves’ disease: a nationwide cohort study. Thyroid. 2013;23:879–84 ; Shu X, Ji J, Li X, Sundquist J, Sundquist K, Hemminki K. Cancer risk in patients hospitalised for Graves’ disease: a population-based cohort study in Sweden. Br J Cancer. 2010;102:1397–9 ; Kwon, H., Moon, BI. Prognosis of papillary thyroid cancer in patients with Graves’ disease: a propensity score-matched analysis. World J Surg Onc 18, 266 (2020). https://doi.org/10.1186/s12957-020-02044-xLuo Y, Zhao Y, Chen K, et al. Clinical analysis of cervical lymph node metastasis risk factors in patients with papillary thyroid microcarcinoma. J Endocrinol Invest. 2019;42(2):227-236. doi: https://doi.org/10.1007/s40618-018-0908-yStaniforth JU, Erdirimanne S, Eslick GD. Thyroid carcinoma in Graves’ disease: a meta-analysis. Int J Surg. 2016;27:118–25Page C, Biet A, Boute P, et al. ‘Aggressive papillary’ thyroid microcarcinoma. Eur Arch Oto-Rhino-Laryngology. 2009;266(12):1959-1963. doi: https://doi.org/10.1007/s00405-009-0952-5Medas F, Erdas E, Canu GL, Longheu A, Pisano G, Tuveri M, et al. Does hyperthyroidism worsen prognosis of thyroid carcinoma? A retrospective analysis on 2820 consecutive thyroidectomies. J Otolaryngol Head Neck Surg. 2018;47:6Yang L, Tan Z, Li Y, et al. Insulin‐like growth factor 1 promotes proliferation and invasion of papillary thyroid cancer through the STAT3 pathway. J Clin Lab Anal. 2020;34(12):1959-1963. doi: https://doi.org/10.1002/jcla.23531Dias Lopes NM, Mendonca Lens HH, Armani A, Marinello PC, Cecchini AL. Thyroid cancer and thyroid autoimmune disease: a review of molecular aspects and clinical outcomes. Pathol Res Pract. 2020;216(9):153098 ; Yoshioka W, Miyauchi A, Ito M, Kudo T, Tamai H, Nishihara E, et al. Kinetic analyses of changes in serum TSH receptor antibody values after total thyroidectomy in patients with Graves’ disease. Endocr J. 2016;63(2):179–85.]Pidchenko NS, Krasnoselskyi MV, Mitriaieva NA, et al. Insulinlike growth factors in the serum of patients with papillary thyroid cancer. Wiadomości Lek. 2021;74(8):1925-1930. doi: https://doi.org/10.36740/WLek202108126Pidchenko NS, Krasnoselskyi MV, Mitriaieva NA, et al. Insulinlike growth factors in the serum of patients with papillary thyroid cancer. Wiadomości Lek. 2021;74(8):1925-1930. doi: https://doi.org/10.36740/WLek202108126Lawnicka H, Motylewska E, Borkowska M, et al. Elevated serum concentrations of IGF-1 and IGF-1R in patients with thyroid cancers. Biomed Pap. 2020;164(1):77-83. doi: https://doi.org/10.5507/bp.2019.018Lawnicka H, Motylewska E, Borkowska M, et al. Elevated serum concentrations of IGF-1 and IGF-1R in patients with thyroid cancers. Biomed Pap. 2020;164(1):77-83. doi: https://doi.org/10.5507/bp.2019.018

The authors declare that there are no conflicts of interest present.