Sarcouncil Journal of Medical Sciences

Abstract: Thyroid nodules are a common type of diagnosis, and their risk of cancerous nature can vary according to the underlying thyroid functional status. Graves' disease is hyperthyroidism, which is an autoimmune stimulation, and this has been considered in the past to have a higher probability of developing thyroid cancer. To make a comparison of the prevalence, cytological risk, histological confirmation, and pathological characteristics of thyroid malignancy in patients with euthyroid nodular goiter compared with Graves' disease. A cross-sectional survey of 113 patients (68 with ENG, 45 with GD) that underwent assessment on thyroid nodules. Clinical evaluation, thyroid activity and antibody test, thyroid ultrasound, and fine-needle aspiration cytology (FNAC, Bethesda classification) were performed on all the patients. A group was subjected to thyroidectomy (n=90). Specimen specimens were studied and categorized based on histology and the series of tumor properties (TNM stage, etc.), as well as molecular markers (BRAF, RAS, TERT). The entire malignancy rate among the operated patients was 27.8 per cent (25/90), although there were no significant tendencies in the higher rate of malignancy in the ENG group (34.6 per cent) over the GD group (18.4 per cent) (p=0.084). The ENG group had better cytological suspicion of malignancy (Bethesda III-VI: 44.1) on the preoperative level as compared to the other group (Bethesda III- VI: 28.9). The papillary thyroid carcinoma was the prevalent one on the histology in the two groups (76.0%). The size of malignant tumors was smaller, and the prevalence of microcarcinomas was higher in GD patients (42.9% vs.33.3%), and BRAF V600E was more common in ENG malignancies (61.1% vs.42.9%). Although the preoperative cytological profile raised more suspicion in euthyroid nodules, the ultimate malignancy rate that was eventually confirmed by surgery was greater in the ENG group. At the time of malignancy diagnosis, pathological aggressiveness, molecular profile, and prognosis seem to be similar in the two groups. These results indicate that nodules in Graves' disease are not more aggressive than those in euthyroid goiter, and the ultrasound and cytological dangerous features should be treated similarly.