A Case of Sarcoidosis, Differentiated Thyroid Carcinoma, and Graves’ Disease in the Thyroid Gland

Author(s):  
Filiz Özülker ◽  
Tamer Özülker
2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Sara Lomelino Pinheiro ◽  
Inês Damásio ◽  
Ana Figueiredo ◽  
Tiago Nunes da Silva ◽  
Valeriano Leite

Background. Mediastinal thyroid carcinoma is extremely rare, with few cases reported in the literature. Case Report. A 73-year-old man presented with weight loss for 6 months. Imaging by computed tomography (CT) documented a large mediastinal mass below the thyroid gland and pulmonary metastases. Neck ultrasound found two spongiform nodules in the right thyroid lobe, and fine-needle aspiration citology (FNAC) of these nodules revealed they are benign. Endobronchial ultrasound-guided needle biopsy of the mediastinal mass was compatible with papillary thyroid cancer. A few weeks later, the patient developed overt hyperthyroidism due to Graves’ disease, which was treated with antithyroid drugs. 99mPertechnetate scintigraphy showed increased diffuse uptake in the thyroid parenchyma but the absence of uptake in the paratracheal mass and in the lung nodules. The patient was not considered eligible for surgical intervention or therapy with tyrosine kinase inhibitor due to tracheal and mediastinal vessel invasion and was treated with palliative radiotherapy. Two months later, restaging PET-FDG showed an intense uptake in the right lobe of the thyroid gland, lymph nodes, lungs, bone, muscle, myocardial, kidney, and adrenal gland. Conclusion. In this case, thyroid carcinoma presented as a mediastinal mass with concurrent hyperthyroidism due to Graves’ disease. Although uncommon, the clinicians should be aware of these situations. Obtaining a prompt histological examination of an intrathoracic mass is crucial to ensure an early diagnosis and treatment.


2019 ◽  
Vol 101 (5) ◽  
pp. e122-e124
Author(s):  
O Hamdy ◽  
S Raafat ◽  
GA Saleh ◽  
K Atallah ◽  
Mahmoud M Saleh ◽  
...  

Primary thyroid carcinoma after thyroid ablation by radioactive iodine is rare. We present a very rare condition of lateral apparent papillary thyroid carcinoma eight years after receiving radioactive iodine for thyrotoxicosis, which led to complete anatomical and functional involution of the thyroid gland.


2019 ◽  
Vol 25 (12) ◽  
pp. 1323-1337 ◽  
Author(s):  
Poemlarp Mekraksakit ◽  
Pattara Rattanawong ◽  
Rudruidee Karnchanasorn ◽  
Chanavuth Kanitsoraphan ◽  
Natnicha Leelaviwat ◽  
...  

Objective: It is still controversial whether differentiated thyroid carcinoma (DTC) in patients with Graves disease (GD) can be more aggressive than non-Graves DTC. We conducted a systematic review and meta-analysis to examine the association between GD and prognosis in patients with DTC. Methods: We comprehensively searched the databases of MEDLINE and EMBASE from inception to March 2019. We included published studies that compared the risk of mortality and prognosis between DTC patients with GD and those with non-GD. Data from each study were combined using the random-effects model. Results: Twenty-five studies from February 1988 to May 2018 were included (987 DTC patients with GD and 2,064 non-Graves DTC patients). The DTC patients with GD had a significantly higher risk of associated multifocality/multicentricity (odds ratio, 1.45; 95% confidence interval, 1.04 to 2.02; I 2, 6.5%; P = .381) and distant metastasis at the time of cancer diagnosis (odds ratio, 2.19; 95% confidence interval, 1.08 to 4.47; I 2, 0.0%; P = .497), but this was not associated with DTC-related mortality and recurrence/persistence during follow-up. Conclusion: Our meta-analysis demonstrates a statistically significant increased risk of multifocality/multicentricity and distant metastasis at the time of cancer diagnosis in DTC patients with GD than those without GD. Abbreviations: CI = confidence interval; DTC = differentiated thyroid carcinoma; GD = Graves disease; LN = lymph node; OR = odds ratio; PTC = papillary thyroid carcinoma; TC = thyroid carcinoma; TSAb = thyroid-stimulating antibody; TSH = thyroid-stimulating hormone


Endocrine ◽  
2019 ◽  
Vol 67 (3) ◽  
pp. 516-525
Author(s):  
Yang Song ◽  
Lijun Fu ◽  
Pu Wang ◽  
Ning Sun ◽  
Xinguang Qiu ◽  
...  

2015 ◽  
Author(s):  
Mustafa Kemal Balci ◽  
Birsen Unsal Koyuncu ◽  
Safiye Arik ◽  
Cumhur Arici ◽  
Ramazan Sari ◽  
...  

2003 ◽  
Vol 50 (3) ◽  
pp. 135-139
Author(s):  
Aleksandar Filipovic ◽  
Ivan Paunovic

The biology of thyroid cancer represents a spectrum of behavior ranging from well - differentiated lesions with an excellent prognosis to anaplastic carcinoma, wich is almost fatal. For this reason, it is important that clinicians have methods at their disposal to asses the characteristics of patient's thyroid malignancy. In this work we discuss the behavior of differentiated thyroid cancer in associated diseases of thyroid as : Graves? disease, chronic lymphocitic thyroiditis - Hashimoto and nodular goiter. This is retrospectively reviewing of 50 patients treated for differentiated thyroid carcinoma at Department of surgery, Clinical Centre of Montenegro in Podgorica from 1998 until 2003. We evaluated occurrence, as well as the role of this diseases in patients with thyroid cancer.We found a more favorable course of thyroid cancer in the presence of chronic lymphocitic thyroiditis and nodular goiter, a contrary Graves? disease. In associated diseases of thyroid, a significantly greater proportion of patients with thyroid cancer, have modular goiter.


2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Ogochukwu Okoli ◽  
Christine A Resta

Abstract A 59 year old woman presented with enlarged thyroid, weight loss, and hot flushes. She had previously been treated for a thyroid problem in 2013 but was lost to follow up. On exam, she had a diffusely enlarged thyroid gland, without distinct nodule. She had brisk DTR’s and mild tremor. Lab results confirmed hyperthyroidism:TSH <0.01 mIU/L (0.27 to 4.2) FT4 2.4 ng/dL (0.9 to 1.8) FT3 7.95 pg/mL (1.8 to 4.6). TSI was 307 % (<140%). Thyroid ultrasound showed a few sub-centimeter nodules, and 2 clinically significant nodules on the right--1.5 x 1.2 x 1.4 cm, cystic with calcifications; and 1.3 x 0.7 x 1.2 cm hypoechoic. I-123 thyroid uptake/scan showed 61% uptake and 2 right sided cold nodules. FNA biopsy showed medullary thyroid carcinoma (MTC) with staining positive for calcitonin and negative for thyroglobulin. CT thyroid showed no adenopathy. Serum calcitonin was 71 pg/mL (<5), and CEA was elevated 5.4 ng/mL (<2.5). Work up was negative for pheochromocytoma and hyperparathyroidism.After pretreatment with methimazole, she underwent total thyroidectomy with bilateral TE groove dissection. Surgical pathology confirmed MTC pT1b pN1a. She was started on levothyroxine therapy post operatively. Discussion There are multiple reports of thyroid carcinoma (papillary and follicular) in Graves disease, but rarely MTC.1 A recent systematic review reports only 21 total cases of MTC in patients with hyperthyroidism, of whom 15 had Graves disease.2 MTC is derived from C-cells from the thyroid gland rather than from follicular cells. TSI, therefore, should not influence development or growth of MTC. Coexistence of the two conditions is likely coincidental rather than causative. ConclusionThyroid nodules in patients with Graves should be worked up as there is a possibility of co-existing thyroid carcinoma. This patient had hyperthyroidism with cold nodules on nuclear scan corresponding to sonographic nodules. Based on these results, she had biopsy leading to diagnosis of MTC. Follow up surgery lead to diagnosis of MTC at earlier stage and provided treatment for both conditions. References1. Staniforth, J. U. etal (2016). Thyroid carcinoma in Graves’ disease: a meta-analysis. International Journal of Surgery, 27, 118-125. 2. Sapalidis, K. etal (2019). A Rare Coexistence of Medullary Thyroid Cancer with Graves Disease: A Case Report and Systematic Review of the Literature. The American journal of case reports, 20, 1398


2015 ◽  
Vol 174 (2) ◽  
pp. 81-83
Author(s):  
O. S. Olifirova ◽  
S. V. Knalyan

An investigation of galectin-3 and thyroglobulin using IFA was conducted in 80 patients. A lavage of aspirate from the thyroid gland was obtained by fine-needle aspiration biopsy. It was stated that significant increase of galectin-3 and thyroglobulin was noted in case of high differentiated thyroid carcinoma in comparison with benign nodules. Galectin-3 and thyroglobulin from the lavage of thyroid gland aspirate could be used as an oncological marker for complex differentiated diagnostics of high differentiated thyroid carcinoma and benign nodules.


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