Endocrine Abstracts

Introduction: The occurrence of Basedow disease does not eliminate the possibility of an associated thyroid cancer. Thyroid carcinoma in Basedow disease is particularly rare (1 to 2%). Most often, it is a papillary carcinoma. This is most often a chance discovery. We report a case of a papillary carcinoma in a Basedow disease taken care of in our department.

Case Report : This was a 39-year-old hypertensive diabetic woman followed in endocrinology for Basedow’ disease under medical treatment, referred to our department for management of an anterior basal cervical swelling rapidly increasing in size. anterior cervical swelling of 6 cm of MA associated with multiple supracentimetric left jugular carotid adenopathy as well as bilateral proptosis. The rest of the ENT examination was without abnormalities. Cervical ultrasound showed a multinodular thyroid goiter with an upper left nodule classified EUTIRADS V associated with bilateral lymphadenopathy, especially at the level of bilateral IIb and IIA chains with a ’thyroid-like’ appearance. The patient had a total thyroidectomy associated with bilateral recurrent mediated dissection and left functional dissection. The frozen section examination found a carcinoma papillary lymphadenopathy and metastatic papillary carcinoma. Definitive anatomy pathology examination confirmed the diagnosis of multifocal and bilateral papillary carcinoma with a crossing of the capsule associated with lymph node metastasis at the level of the adenopathy of the recurrent and lateral mediastinal dissection. The patient was referred to IRAtherapy, she received 100 Mci of radioactive iodine with white cartography with good evolution without recurrence after one year of follow-up.

Conclusion : According to data from the literature, the incidence of thyroid cancer in Basdewo disease is rare (0.1 – 9.8%). The histological type is a papillary carcinoma in most cases.•The subsequent management is similar to that of differentiated thyroid cancers, namely isotopic ablation at I131 and a braking treatment with L-thyroxine.