A Uniquely Challenging Case of Poorly Controlled Hyperthyroidism With a Coexisting Thyroglossal Cyst

Area of Science:

• Endocrinology
• Congenital Anomalies

Background:

• Graves' disease is a common cause of hyperthyroidism.
• Thyroglossal duct cysts are frequent congenital anomalies.
• The simultaneous occurrence of Graves' disease and a non-complicated thyroglossal duct cyst is exceptionally rare.

Observation:

• A 44-year-old female with a history of poorly controlled Graves' disease, diagnosed 16 years prior, also had an incidental thyroglossal duct cyst.
• The patient initially received anti-thyroid medication but remained hyperthyroid, delaying definitive treatment due to personal preference.
• She eventually presented with thyroid storm, necessitating total thyroidectomy and cyst resection.

Findings:

• This case presents a unique instance of Graves' disease coexisting with a non-complicated thyroglossal duct cyst, without evidence of ectopic hormone production.
• It illustrates the natural progression of untreated Graves' disease in the presence of a thyroglossal duct cyst.
• Management challenges associated with non-compliant patients and poorly controlled hyperthyroidism were observed.

Implications:

• This case underscores the importance of patient adherence in managing hyperthyroidism.
• It contributes to the limited literature on the co-occurrence of Graves' disease and thyroglossal duct cysts.
• The findings offer insights into the natural history of untreated Graves' disease in rare concurrent conditions.