Endocrine Abstracts

Introduction: Involvement of different tissues and organs may be seen during the course of Graves’ disease (GD). We here aimed to present a case with GD and lung mass whose lung lesion disappeared after recieving antithyroid treatment.

Case report: A 60 year old man admitted to our hospital with back pain. His thorax computed tomography (CT) revealed a 1.5×3 cm mass in lower right lobe. He was consultated by our clinic preoperatively before thoracotomy for his thyroid function test (TFT) revealing overt hypertyroidism. On laboratory evaluation; TSH:0.004 μIU/ml (0.4–4.0), fT₃:9.1 pg/ml (1.57–4.71), fT₄:3.23 ng/dl (0.8–1.48), anti-TPO(+) anti-Tg(+) CRP:1.2 mg/l ESR:10 mm/h were recorded. Thyroid ultrasonography revealed hypervascular enlarged thyroid lobes with heterogeneous apperance. Radioactive iodine uptake performed 2 months after iodine exposure from the radiocontrast substance revealed increased uptake. He was started methimazole tretment and his lung surgery was postponed. Two months later his TFT was euthyroid and referred for thoracotomy. He had another thorax CT which showed that the mass in the right lobe of the lung almost totally resolved after which the surgery was cancelled (Fig. 1). He didn’t show any sign or symptom of a systemic inflamatory disease that could explain the transient mass lesion in the lung.

Conclusion: Thionamides used in the treatment of hyperthyroidism has also been shown to exhibit immunmodulatory effects, direct anti-inflammatory and immunosupressive properties. This drug group has been associated with protection from chronic inflammation and autoimmune disorders. During the course of antithyroid treatment, remission of some immune-related diseases have been reported. However, there is not enough evidence to associate the disapperance of the lung mass with the antithyroid treatment in our case. This is expected to be coincidental rather than causally related.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Figure 1. Chest CT before and after methimazole treatment

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.