Endocrine Abstracts

Objective: Thyrotoxicosis have received wide attention from researchers over the last century as it an important cause of secondary osteoporosis. Most of the cases present mild osteoporosis.

Design: We present the case of a old women (77 years) with no thyroid disease in medical history, only with stable hypertension and artrosis. She was sent to endocrine exam by the oncologyst because she started to have intense lumbal painand the MRI describe osteolitical areas in Th12 and L2, L3. Achieving positron emission tomography–computed tomography (PET–CT) showed that the thoraco-lumbar spine lesions were not metastases only serious osteoporotic areas and also identified a nodule with high sensitivity to 18-FDG in right thyroid lobe 6 cm. The ultrasound demonstrate a hipoecoic nodule with intense vascularization about 6 cm, and radioioduptake showed an intense uptake in this nodule and TSH was 0.0003 μUI/ml. FNA was performed and the result excluded a malign lezion. We recommend thyroidectomy and the final hystopathologic exam was benign.

Results: The diagnose was toxic solitary autonomous thyroid nodule with severe osteoporosis wich mimicks bone metastasis at the begining.

Conclusion: Hyperthyroidism, even with mild simptoms may be a contributing factor to the development of osteoporosis in some post-menopausal women, mostly at lumbal sites. A solitary autonomously functioning thyroid nodule affects bone metabolism and is a risk factor for osteoporosis.