2026 Poster Presentations
P521: VESTIBULAR SCHWANNOMA AND HYPOTHYROIDISM: EXPLORING A POSSIBLE LINK?
Eric M Cohen, BS1; Alec Dallas, BS1; Bryan Clampitt, BS1; Mohammad Hassan A Noureldine, MD, MSc2; Siviero Agazzi, MD, MBA2; 1University of South Florida Morsani College of Medicine; 2Department of Neurosurgery and Brain Repair, University of South Florida Morsani College of Medicine
Background: There have been no studies exploring a potential association between thyroid dysfunction and vestibular schwannoma (VS). This preliminary study describes the prevalence of clinically diagnosed thyroid disorders in a single-center VS cohort and explores clinical outcomes.
Methods: A retrospective cohort of 266 patients who underwent intervention for VS was analyzed. Patients were categorized based on thyroid status prior to treatment for VS. Patients were categorized by clinical thyroid status prior to VS treatment, defined by a documented diagnosis and/or use of thyroid replacement medication. Categories included hypothyroidism, hyperthyroidism, and other thyroid disorders. Statistical comparisons used chi-square goodness-of-fit tests, ANOVA, and multivariable linear regression.
Results: Thyroid dysfunction was present in 19.9% (n=53/266): hypothyroidism 15.4% (n=41), other thyroid disorders 3.8% (n=10; nodules n=5, Hashimoto’s n=4, tumor n=1), and hyperthyroidism 0.8% (n=2). The mean age was 54.5 years. Compared with two U.S. reference estimates, hypothyroidism prevalence in the VS cohort was higher: versus NHANES (4.6%), [OR = 3.75 (95% CI 2.65–5.30), χ² = 69.96, p < 0.0001]; and versus ARIC (6.88%), [OR = 2.47 (95% CI 1.74–3.50), χ² = 30.24, p < 0.0001]. Patients with hypothyroidism were older at surgery than those without thyroid disorder (58.9 vs 53.4 years; ANOVA F = 5.238, p = 0.023). Tumor size did not differ on unadjusted analysis (ANOVA F = 3.85, p = 0.051); in multivariable linear regression controlling for age and MFI-5, any thyroid disorder was associated with smaller tumor size (B = −0.42 cm, p = 0.038). Overall model fit was modest (adjusted R² = 0.025; F = 2.75, p = 0.044).
Conclusion: In this single-center retrospective cohort, hypothyroidism was more frequent among VS patients than in two reference U.S. populations. The adjusted association between thyroid disorder and smaller tumor size was statistically significant but small in magnitude, with limited model explanatory power. These findings should be considered hypothesis-generating: they neither establish a causal relationship between thyroid dysfunction and VS nor support any change to diagnostic imaging practices for individuals with thyroid disease. Further study with detailed thyroid phenotyping and rigorous sensitivity analyses is warranted to assess robustness and potential sources of bias, including age distribution, comorbidity, frailty, and healthcare-utilization differences.