ECE2023 Eposter Presentations Thyroid (128 abstracts)
Papillary thyroid carcinoma and Graves’ disease: a case report
Houas Jihene 1 , Ben Arfi Taissir 1 , Ghammam Monia 1 , Lazid Sarra 1 , El omri Malika 1 , Bellakhdher Mouna 1 , Hasni El Abed Yosra 2 , Meherzi Abir 1 , Kermani Wassim 1 & Abdelkefi Mohamed 1
1ENT Department and Neck Surgery of Farhat Hached Hospital, Sousse, Tunisia, 2Endocrinology Department Farhat Hached Hospital, Sousse, Tunisia
Introduction: The occurrence of a thyroid cancer on Graves’ disease is rare (0.3 to 16.6%). Most often than not, the type found is a papillary carcinoma and is discovered incidentally. Finding a thyroid nodule within the goiter must always raise suspicion of malignancy.
Material and methods: We report the case of a patient followed for Grave’s disease in whom a fortuitous association with differentiated thyroid cancer was discovered on a pathological examination.
Observation: A 51-year-old patient with no significant pathological history was hospitalized for an anterior cervical swelling, associated with clinical signs of hyperthyroidism, meanwhile no signs of compression were found. Physical examination revealed an enlarged thyroid with a 2.5 cm right nodule. The lymph node areas were free. The hormonal assessment revealed a profile of a peripheral hyperthyroidism. The cervical ultrasound revealed a multinodular goiter with thyroid nodules classified EUTIRADS 5 on the right side and EUTIRADS 3 on the left side. A thyroid scan showed bilateral l hypo fixing foci. The treatment was initially based on the administration of synthetic anti-thyroid drugs. The evolution was marked by partial improvement of the clinical and biological hyperthyroidism. The patient underwent a right lobo-isthmectomy with an extemporaneous examination that identified a papillary carcinoma of the thyroid, hence the thyroid totalization with a central lymph nodes dissection. Histological examination revealed a 23 mm papillary carcinoma of the right lobe with one metastatic lymph node alongside with a remodeled thyroid parenchyma compatible with Graves’ disease. A complementary radiation therapy (3 courses of 100 mCi) was instituted. The evolution was favorable with no signs of recurrence nor extension. The current follow-up goes up to 6 years.
Conclusion: Diagnosing a patient with Graves’ disease should never later on blind the physician on a possible association with a thyroid cancer. The subsequent management is similar to that of differentiated thyroid cancers and the prognosis is usually good enough.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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