ECE2024 Eposter Presentations Thyroid (198 abstracts)
1La Rabta University Hospital, Endocrinology Department, Tunis, Tunisia
Introduction: Hashimotos thyroiditis is the most frequent cause of hypothyroidism with a relative increased risk of thyroid lymphoma compared to healthy subjects. Hyperfunctioning nodules are rarely malignant. We report the case of a rare association of thyroid carcinoma, a hyperfunctioning nodule and Hashimoto thyroiditis.
Observation: We report the case of a 40-year-old female patient treated with L-thyroxine for hypothyroidism due to Hashimoto thyroiditis for 3 years. Thyroid ultrasonography was performed due to suspicion of thyroid nodule at the clinical examination and showed a 13 mm EUTIRADS 3 thyroid nodule, which increased in size to 27 mm after 12 months. Fine needle aspiration showed a benign cytology. During monitoring, TSH levels dropped to 0.005 mIU/l after withdrawal of L-Thyroxine. Thyroid scintigraphy showed a solitary hyperfunctioning nodule. The patient had a total thyroidectomy following suspicion of carcinoma on extemporaneous examination. The definitive pathological examination of that nodule concluded to a 1 mm vesicular thyroid carcinoma within the nodule.
Conclusion: The association of a solitary hyperfunctioning nodule and Hashimotos thyroiditis is rarely described in the literature. The majority of autonomous nodules are benign. However, in case of clinical or ultrasound criteria of malignancy, surgery is required and can reveal malignancy.