Papillary Thyroid Carcinoma in Patients with Acromegaly from a Single Center in China

OBJECTIVES: An increased risk of thyroid cancers in patients with acromegaly has been addressed by numerous studies. However, the differences between patients with papillary thyroid cancer (PTC) with and without acromegaly remain to be clarified. We compared the clinical-pathologic data and genetic alterations of PTC between the 2 groups. PATIENTS AND METHODS: Four patients with PTC and acromegaly and 32 age-matched patients with PTC without acromegaly were retrieved retrospectively from the hospital recordings. Mutational analysis was determined by direct sequencing. Insulin-like growth factor-1 receptor and insulin Rb expression were analyzed by immunohistochemistry in acromegaly group. RESULTS: The prevalence of multifocality involved in bilateral lobes in the acromegaly group was significantly increased (P = 0.017). The presence of bilateral lymph node metastasis showed the increasing trend even though without a significant difference because of the limited umber of PTC patients in acromegaly group (P = 0.053). There was no significant difference in other factors, such as sex, tumor size in maximum diameter, lymph node metastasis, extrathyroidal extension, and TNM stage. Two (50%) PTCs in acromegalic group and 25 (78.12%) PTCs in the nonacromegalic group were detected to harbor BRAF(600E) mutation, and no patient was identified to have NRAS codon 61, KRAS codon 61/12/13 mutation. Insulin like growth factor-1 receptor and insulin R beta immunostaining showed low positive to positive in PTC cells and negative in adjacent normal tissues in patients with acromegaly. CONCLUSIONS: Multifocality involved in 2 lobes is more common in patients with PTC and acromegaly, which shows more aggressive behaviors. BRAF mutation is not u ncommon in patients with PTC and acromegaly.