Late-onset Graves' disease after hemithyroidectomy: a case report

Area of Science:

• Endocrinology
• Thyroidology
• Surgical Oncology

Background:

• Graves' disease is the most common cause of hyperthyroidism, typically affecting individuals aged 30-60.
• Hemithyroidectomy, a partial thyroid removal, is performed for conditions like thyroid tumors.
• Postoperative Graves' disease developing in residual thyroid tissue after hemithyroidectomy is exceptionally rare.

Purpose of the Study:

• To report two rare cases of elderly patients developing Graves' disease years after hemithyroidectomy.
• To review the literature on the occurrence of Graves' disease following hemithyroidectomy.
• To discuss potential mechanisms and diagnostic considerations for late-onset Graves' disease post-surgery.

Main Methods:

• Presentation of two distinct case studies of post-hemithyroidectomy Graves' disease.
• Detailed patient demographics, surgical history, and diagnostic timelines.
• Literature review on similar rare occurrences and potential etiologies.

Main Results:

• Case 1: A 71-year-old female developed Graves' disease 3 years after hemithyroidectomy for papillary cancer.
• Case 2: A 75-year-old female developed Graves' disease 8 years after hemithyroidectomy for follicular adenoma.
• Both cases highlight the delayed onset of Graves' disease years after thyroid surgery.

Conclusions:

• Late-onset Graves' disease following hemithyroidectomy is a rare clinical event.
• Potential contributing factors include thyroid antigen release or a prolonged subclinical disease phase.
• Emphasizes the importance of postoperative monitoring, including thyroid-stimulating hormone receptor antibody (TRAb) measurement, for early diagnosis.