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Optimal actions in the maternal thyroid hormones (THs; 3,5,3'-triiodothyronine (T3) and thyroxine (T4)) during pregnancy are central to a normal fetal and neonatal consequence (Elbakry et al., 2010; Ahmed, 2011, 2012a,b, 2013, 2014, 2015a-c, 2016a-d, 2017a-v, 2018a-u; Ahmed and Ahmed, 2012; Ahmed et al., 2008; 2010; 2012; 2013a,b, 2014, 2015a,b, 2018a,b; Ahmed and Incerpi, 2013;Van Hercket al., 2013; Ahmed and El-Gareib, 2014,Incerpi et al., 2014; Candelotti et al., 2015; De Vito et al., 2015; El-Ghareeb et al., 2016; Ahmed and ElGareib, 2017). On the other hand, a controversial association between THs and cancer was observed. Some authors postulating that hyperthyroidism can induce cancer development and progression (Gabriele et al., 2003; Furumoto et al., 2005; Davis et al., 2006; Nishida et al., 2008; Kress et al., 2010), although others have stated a tumor inhibition action of THs (Ruiz-Llorente et al., 2011; Manka et al., 2018). Galdiero et al. (2016) reported that about 90% of the endocrine malignancies are a thyroid cancer. A toxic nodular goiter (TNG) can increase the risk of metastatic follicular thyroid carcinoma (FTC) (Sahin et al., 2005). It appears that the prediction of metastatic follicular carcinoma does not fluctuate with the attendance or lacking hyperthyroidism (Tsuchiya et al., 1987; Paul and Sisson, 1990; Lin et al., 2004; Giovanella et al., 2010). As well, Cakir et al. (2007) suggested that the prevalence of thyroid carcinoma was lower in subjects with Graves' disease than in subjects with toxic adenoma (TA) or toxic multi nodular goiter (TMG). Several investigators reported that Graves’ disease (20-25%) is the utmost communal cause of hyperthyroidism and the frequency of thyroid nodules (Pacini et al., 1998; Kraimps et al., 2000; Taneri et al., 2005). Indeed, cancer related to Graves' disease appears to be more destructive than those linked to multi nodular toxic goiter (MTG) or uni nodular toxic goiter (UTG) (Cappelli et al., 2006). In addition, Wong et al. (2003) observed that thyrotoxicosis in women was associated with Hurthle cell carcinoma of the thyroid (a rare type of thyroid neoplasm).

Maternal Hyperthyroidism and Developing Thyroid Cancer: What is the Next?