Cutaneous Melanoma and Papillary Thyroid Carcinoma: Mutual Increased Risk
In a study reported in JAMA Otolaryngology-Head & Neck Surgery, Oakley et al found that papillary thyroid cancer increases the risk of cutaneous malignant melanoma and vice versa. In addition, the investigators found that patients with both cancers have a high frequency of BRAF V600E mutation.
Study Details
This retrospective review used the Utah Population Database, which is linked to both medical records and the Utah Cancer Registry from 1966 to 2011, to identify the relative risk of papillary thyroid cancer in patients with melanoma and vice versa and identify risk in their first-through fifth-degree relatives and spouses. Tissue analysis in a tertiary care facility assessed the rate of BRAF V600E mutation in a group of patients with both diagnoses.
The study included 4,460 patients diagnosed with papillary thyroid cancer and 14,569 with melanoma in Utah between 1966 and 2011 and their relatives and spouses. Cases were compared at a 1:5 ratio with matched population-based controls (n = 22,300 for papillary thyroid cancer and 72,845 for melanoma).
Increased Risks
Patients with melanoma had a significant 2.3-fold increased risk (odds ratio [OR] = 2.3, P < .001) of being diagnosed with papillary thyroid cancer compared with controls. A borderline increased risk of papillary thyroid cancer was observed in the combined group of first- and second-degree relatives of melanoma cases (OR = 1.2, P = .05).
Patients with papillary thyroid cancer had a significant 1.8-fold increased risk (OR = 1.8, P < .001) of developing melanoma compared with controls. A borderline increased risk of melanoma was observed in the combined group of first- and second-degree relatives (OR = 1.1, P = .05) and in third-degree relatives (OR = 1.1, P = .05) of papillary thyroid cancer cases.
BRAF V600E Mutation
Among nine patients diagnosed with both papillary thyroid cancer and melanoma who had tissue specimens available, both thyroid and melanoma tissue specimens were available for eight. Among the eight patients, four (50%) tested positive for BRAF V600E mutation in at least one specimen and three (38%) tested positive in both.
The investigators concluded: “Patients with either [papillary thyroid cancer] or [cutaneous malignant melanoma] have an increased risk of developing the other cancer as a second primary malignant neoplasm. Tissue specimens from patients with both cancers show a high rate of BRAF V600E mutation. Translational studies are needed to better define the associated genetic predisposition between [papillary thyroid cancer] and [cutaneous malignant melanoma] and to test the efficacy of and implementation techniques for treatment plans using BRAF mutation as a therapeutic target.”
Gretchen M. Oakley, MD, of University of Utah School of Medicine, is the corresponding author for the JAMA Otolaryngology-Head & Neck Surgery article.
The study was supported by the National Cancer Institute, Utah State Department of Health, University of Utah, and others.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
