Papillary Thyroid Carcinoma Differential Diagnoses

Updated: Feb 06, 2018
  • Author: Ponnandai S Somasundar, MD, MPH, FACS; Chief Editor: Neetu Radhakrishnan, MD  more...
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DDx

Diagnostic Considerations

Patients with a history of Hashimoto thyroiditis are at increased risk for papillary thyroid cancer. In a study by Bradly et al, the overall incidence of incidental papillary carcinoma (IPC) in benign operatively resected thyroid disease was 12%, with Hashimoto thyroiditis being associated with the highest rate of IPC. [35] According to this study and others, the association of IPCs with Hashimoto thyroiditis may indicate a link to thyroid cancer. [36]

A study by Spencer concluded that in patients with Hashimoto thyroiditis, thyroglobulin autoantibody trends may be used as a surrogate differentiated thyroid carcinoma tumor marker and are superior to thyroglobulin immunometric assay findings, provided that the same method is used. [37] Because of the increased risk of PTC, total thyroidectomy may be considered appropriate in patients with Hashimoto thyroiditis and large follicular adenoma requiring operation.

Differential Diagnoses