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Related Experiment Videos

Medullary thyroid carcinoma mimicking an autonomous functioning nodule

I Rivas1, C Gutiérrez, J Vendrell

  • 1Internal Medicine Department, Hospital Joan XXIII, Tarragona, Spain.

Journal of Endocrinological Investigation
|March 1, 1995
PubMed
Summary
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This case report details the first instance of medullary thyroid carcinoma (MTC) presenting within a hyperfunctioning thyroid nodule. Early fine needle biopsy is recommended for all thyroid nodules to detect potential associated carcinomas.

Area of Science:

  • Endocrinology
  • Oncology
  • Pathology

Background:

  • Medullary thyroid carcinoma (MTC) is a neuroendocrine tumor arising from parafollicular C-cells.
  • Autonomous thyroid nodules typically present as hyperfunctioning lesions on scintigraphy.
  • Malignancies within functioning thyroid nodules are rare but clinically significant.

Observation:

  • A 42-year-old woman initially diagnosed with a hyperfunctioning autonomous thyroid adenoma was found to have medullary thyroid carcinoma (MTC).
  • The MTC was located within the autonomously functioning thyroid nodule.
  • Scintigraphy revealed a "hot nodule," indicative of hyperfunction.

Findings:

  • Histopathological and immunohistochemistry studies confirmed MTC despite the initial diagnosis of a benign adenoma.

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  • This represents the first reported case of MTC associated with thyroid hyperfunction presenting as a hot nodule.
  • The findings highlight a potential diagnostic challenge in differentiating benign hyperfunctioning nodules from those harboring malignancy.

    • Implications:

    • The study suggests a need for systematic fine needle biopsy (FNB) in all thyroid nodules, regardless of their functional status on scintigraphy.
    • Early detection of MTC within functioning nodules can improve patient outcomes.
    • This case underscores the importance of comprehensive histopathological evaluation for accurate thyroid nodule diagnosis.