Incidental thyroid carcinoma in patients with Graves' disease

BACKGROUND: The clinical significance of incidental thyroid carcinoma in patients with Graves' disease is uncertain. METHODS: The prevalence of incidental thyroid carcinoma was determined in patients with Graves' disease who underwent surgery from 1990 to 2007 and was compared with patients with nontoxic nodular goiter or toxic multinodular goiter who underwent surgery during the same time period. RESULTS: Of the 93 patients who underwent thyroidectomy for Graves' disease, 2 patients (2.2%) had an incidental papillary carcinoma: .4 and .5 cm in size. Neither patient developed recurrent disease after 3 and 13 years of follow-up evaluation. The prevalence of incidental thyroid cancer was 3.6% and 6.2% in patients with nontoxic nodular goiter and toxic multinodular goiter, respectively (P = not significant). CONCLUSIONS: The prevalence of incidental thyroid carcinoma in patients with Graves' disease is comparable with patients with nontoxic or toxic goiter. Incidental thyroid carcinomas in patients with Graves' disease were papillary microcarcinomas of no clinical consequence.