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Arq Bras Endocrinol Metabol ; 57(4): 307-11, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23828435

RESUMO

OBJECTIVE: To analyze the presentation, follow-up and evolution of differentiated thyroid cancer (DTC) detected during pregnancy. SUBJECTS AND METHODS: Twenty nine women with DTC detected during pregnancy were analyzed. Group I (n = 13) was seen during pregnancy and DTC was diagnosed during gestation; detection of the nodule occurred during pregnancy (first trimester). Group II (n = 16) was seen after delivery; detection of the nodule occurred during pregnancy (second or third trimester). Complete thyroidectomy, ablative dose of radioactive iodine, and treatment with levothyroxine were performed. FOLLOW-UP: neck ultrasound; TSH, free T4, thyroglobulin, and anti-thyroglobulin antibodies with and without treatment with levothyroxine; and 131I whole body scans. Histological diagnosis, lymph node metastases, tumor size and stage, complications from pregnancy, and DTC evolution were evaluated. RESULTS: 100% of the patients had papillary thyroid carcinoma. Lymph node metastases were detected in 13 (44.8%), and invasion of adjacent extrathyroid tissue in 2 patients. Tumor size was larger in Group II: 22.1 ± 10.9 versus 13.9 ± 3.5 mm; p = 0.03. No differences were found in the tumor stages between groups. All patients had full-term pregnancies and healthy newborns. FOLLOW-UP: 5.7 ± 4.3 years; one patient had persistent disease. CONCLUSIONS: DTC detected during pregnancy had a favorable evolution. Surgery may be postponed to the post-delivery period, unless there are risk factors that justify it during pregnancy.


Assuntos
Carcinoma Papilar/patologia , Complicações Neoplásicas na Gravidez/patologia , Gestantes , Neoplasias da Glândula Tireoide/patologia , Tiroxina/uso terapêutico , Adulto , Argentina , Carcinoma Papilar/terapia , Progressão da Doença , Feminino , Seguimentos , Humanos , Radioisótopos do Iodo/uso terapêutico , Pescoço/diagnóstico por imagem , Estadiamento de Neoplasias , Gravidez , Complicações Neoplásicas na Gravidez/terapia , Trimestres da Gravidez , Neoplasias da Glândula Tireoide/terapia , Tireoidectomia , Ultrassonografia
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