ECE2013 Poster Presentations Thyroid cancer (64 abstracts)
Thyroid papillary carcinoma in a toxic adenoma: case report
Raquel G Martins 1, , Joana Couto 1 , Ana Paula Santos 1 , Maria João Matos 3 , Rosa Capelo 1 , José Pedro Silva 1 , Inês Lucena 1 , Mariana Cambão 1 & Isabel Torres 1
1Portuguese Institute of Oncology, Oporto, Portugal; 2School of Medicine, University of Oporto, Oporto, Portugal; 3São João Hospital, Oporto, Portugal.
Introduction: Malignant toxic thyroid nodules are rare, with few cases described in the literature. The prevalence of malignancy in toxic adenomas varies between 1 and 8% in different series (most, corresponding to <2.5%). For that reason, international guidelines recommend that they should not be submitted to fine needle aspiration biopsy.
Case report: A 42-year-old female patient without relevant previous medical history was admitted to our hospital because of two thyroid nodules (37 e 13 mm) in the left lobe (without adenopathies); analytically, she had subclinic hyperthyroidism. Fine needle aspiration biopsy diagnosis was colloid nodular hyperplasia; 131I scan showed tracer activity in a left nodule with suppression of extranodular tissue. Thyroid hormone measurements were repeated and were compatible with clinical hyperthyroidism. She was initially treated with methimazole and then submitted to left hemithyroidectomy which showed a thyroid papillary carcinoma (folicular variant) in both nodules associated with a lymph node metastasis. She was finally submitted to total thyroidectomy (remaining tissue didn’t present neoplastic involvement) and 131I ablative treatment and remains under surveillance with levothyroxine suppressive therapy.
Conclusions: The authors describe a rare association of hot nodules and papillary thyroid carcinoma, with a nondiagnostic cytology, stressing the importance of long-term surveillance of toxic nodules that underwent nonsurgical therapies. Published cases of differentiated thyroid carcinoma appearing in hot nodules seem to suggest a similar prognosis to that present in nontoxic nodules.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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