Hyperfunctioning papillary thyroid carcinoma - a case report and literature review.

Area of Science:

• Endocrinology
• Oncology
• Nuclear Medicine

Background:

• Malignant hyperfunctioning thyroid nodules are uncommon, with follicular thyroid cancer being a more frequent association than papillary variants.
• This study details a rare case of papillary thyroid carcinoma manifesting within a hyperfunctioning thyroid nodule.

Approach:

• A case study involving a single adult patient who underwent total thyroidectomy for thyroid carcinoma within a hyperfunctioning nodule.
• Literature review was conducted to contextualize the findings.

Key Points:

• A 58-year-old male presented with subclinical hyperthyroidism (low TSH) and a suspicious right thyroid nodule.
• Initial fine needle aspiration suggested a follicular lesion of undetermined significance, but a subsequent 99mTc thyroid scintigram revealed a hyperfunctioning nodule.
• Further cytology confirmed papillary thyroid carcinoma, leading to total thyroidectomy with confirmed tumor-free margins.

Conclusions:

• Hyperfunctioning malignant nodules, though rare, necessitate careful clinical evaluation due to significant implications.
• Selective fine needle aspiration is recommended for all suspicious thyroid nodules measuring 1 cm or larger.