Thyroid Malignancy and Grave’s Disease

Rajni K Sah¹, Sabaretnam Mayilvaganan²

^1,2Department of Endocrine and Breast Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India

Corresponding Author: Sabaretnam Mayilvaganan, Department of Endocrine and Breast Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India, Phone: +91 9655851510, e-mail: drretnam@gmail.com

How to cite this article: Sah RK, Mayilvaganan S. Thyroid Malignancy and Grave’s Disease. Indian J Endoc Surg Res 2024;19(1):1.

Source of support: Nil

Conflict of interest: None

Dear Editor,

We read with interest the article “Association of thyroid malignancy and Grave’s disease: A South India Tertiary Care Center perspective” by Sahithi Priya, et al.¹ We congratulate the authors on addressing this issue of malignancy in Grave’s disease and for their successful surgical management. The definitive management of Grave’s disease includes radio-active iodine ablation or surgical management and in this robotic era, the surgical management may be open total thyroidectomy, endoscopic total thyroidectomy, and robotic total thyroidectomy with the knife happy surgeon preserving the parathyroid and Recurrent Laryngeal Nerves. We agree with the authors regarding their observation of ultrasonography not picking up sub-Cen trimetric foci of malignancy in Grave’s disease before surgery and also increased incidence of malignancy in Grave’s disease.²

We have a few queries which may interest future readers. Did the authors subject these patients to contrast-enhanced computed tomography? Did the authors routinely do thyroid scintigraphy (Tc99-m)? Did they use Lugol’s iodine for preoperative preparation?³ Did they find Central compartment nodes in the malignancy group and did they do CCLND? What was the rate of hypocalcemia in both groups?

Thank you for your comments on these issues.

REFERENCES

1. Boddukura SP, Sadacharan D, Selvambigai G, et al. Association of thyroid malignancy and Graves’ disease: A south Indian tertiary care center perspective. Indian J Endoc Surg Res 2023;18(2):45–48. DOI: 10.5005/jp-journals-10088-11220.

2. Park SK, Ryoo JH, Kim MH, et al. Association between eight autoimmune diseases and thyroid cancer: A nationwide cohort study. Thyroid 2024;34(2):206–214. DOI: 10.1089/thy.2023.0353.

3. Reddy AC, Sabaretnam M. Lugol’s iodine in Graves’ disease–Revisited. Int J Surg 2016;36(Pt A):30–31. DOI: 10.1016/j.ijsu.2016.10.018.

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