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The Thyroid Gland01:23

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The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
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Hyperfunctioning papillary thyroid carcinoma: A case report with literature review.

Abdulwahid M Salih1, F H Kakamad2, Han Nihad3

  • 1Faculty of Medical Sciences, School of Medicine, Department Surgery, University of Sulaimani, François Mitterrand Street, Sulaymaniyah, Iraq.

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This study reports a rare case of papillary thyroid cancer in a patient with hyperthyroidism. It highlights that thyroid malignancy should be considered in hyperthyroid goiter cases.

Keywords:
HyperthyroidismKi-RASPapillary thyroid carcinomaThymoglobulin

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Area of Science:

  • Endocrinology
  • Oncology
  • Pathology

Background:

  • Thyroid malignant tumors rarely present with hyperfunctioning thyroid.
  • The co-incidence of thyroid cancer and hyperthyroidism is highly variable.
  • This report details a rare case of papillary thyroid cancer associated with hyperthyroidism.

Purpose of the Study:

  • To report a rare case of papillary thyroid cancer in a patient with hyperthyroidism.
  • To review the literature on the association between thyroid malignancy and hyperthyroidism.
  • To emphasize the importance of considering thyroid malignancy in the differential diagnosis of hyperthyroid goiter.

Main Methods:

  • A 40-year-old male presented with symptoms of hyperthyroidism and neck swelling.
  • Diagnostic workup included thyroid function tests, neck ultrasound, and ultrasound-guided fine needle aspiration cytology.
  • The patient underwent total thyroidectomy, confirmed histopathologically as papillary thyroid carcinoma.

Main Results:

  • Thyroid function tests indicated hyperthyroidism (elevated free T3 and free T4, suppressed TSH).
  • Neck ultrasound revealed nodules with features suggestive of malignancy.
  • Fine needle aspiration cytology and subsequent histopathology confirmed papillary thyroid carcinoma.

Conclusions:

  • Literature review indicates an increasing association between elevated thyroid function tests and thyroid malignancy.
  • The hyperfunction in thyroid malignancy may be linked to gene mutations, such as TSH receptor mutations.
  • Thyroid malignancy should be considered in the differential diagnosis of hyperthyroid goiter, despite its rarity.