2018 年 88 巻 2 号 p. 51-56
Background: Non-specific complaints are common in women, and tend to be diagnosed as menopausal disorders or autonomic imbalance without adequate examination. In Women Specific Clinic (WSC), we carry out a careful differential diagnosis on the basis of patients' complaints, taking account of women's mental and physical characteristics. One point that warrants particular attention is that many non-specific complaints resemble the symptoms of thyroid dysfunction and malignant tumor (MT). Thyroid cancer (TC), 90 % of which is papillary thyroid carcinoma (PTC), is also about three times more common in women than in men. TC is commonly diagnosed at a younger age than other adult-onset cancers, and the risk of TC peaks earlier in women than it does in men, being highest in the 40s and 50s, around the age of menopause.
We therefore focused on MT and PTC as a common female cancer that often coincides with menopause, and investigated the prevalence and attributes of patients diagnosed with PTC in our clinic as well as the diagnostic process.
Materials and Methods: We investigated the prevalence and type of malignancy and the diagnostic process for those patients diagnosed with PTC out of 668 patients who were first examined in WSC between June 2011 and June 2012.
Results: MT was identified in 6 of 668 patients (0.9 %) and PTC was identified in 4 of 668 patients (0.6 %) examined during this 1-year period. The attributes and complaints of these patients varied; the common factor was the fact that the physician listened carefully to symptoms peripheral to the principal complaint and carried out the appropriate investigation (ultrasonography) required for a differential diagnosis.
Conclusions: Women tend to experience a variety of menstruation-related and menopausal symptoms that present as non-specific complaints. These may easily mask the symptoms of underlying disease such as PTC in menopausal or premenopausal woman. At women's medicine, health providers should be aware of this point and conduct a careful differential diagnosis.
