Endocrine Abstracts

Introduction: A toxic goiter is a goiter that functions autonomously, causing hypersecretion of thyroid hormones, and is almost always benign. We report here the case of a toxic goiter that revealed the presence of papillary thyroid carcinoma.

Observation: Patient aged 68, with a history of arterial hypertension, followed for hyperthyroidism on a toxic goitre, with a thyroid scintigraphy showing an enlarged thyroid gland with intense uptake on the right side, an ultrasound scan showed a multiheteronodular goiter with nodules classified EUTIRADS 3 and 5. Antithyroid antibodies were negative, which led to her being put on TSA and beta-blockers, and the patient underwent surgery after euthyroidism. Pathological examination revealed an invasive variant vesicular papillary carcinoma of the right lobe of the thyroid measuring 1.5 cm long, with the presence of vascular emboli, and an invasive variant vesicular papillary microcarcinoma of the left lobe of the thyroid measuring 0.5 cm long, with the presence of vascular emboli. The tumour was classified as PT2NxMx at intermediate risk of recurrence. Iratherapy was considered and the patient was put on hormone replacement therapy with l. Thyroxine.

Discussion and conclusion: Differentiated thyroid carcinoma usually occurs in euthyroidism. The association of papillary thyroid carcinoma with hyperthyroidism is exceptional. The prevalence of this association varies from 0.2 to 8.3%. This has led to widely adopted recommendations by several expert groups not to perform cytopuncture on these lesions. Our case has shown that the risk of malignancy in toxic goitres is not zero, hence the need to resort to cytopuncture in the presence of elements in favour of malignancy.