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[Hyperfunctioning thyroid carcinoma. Description of a case]

C Pandolfi1, M Colecchia, A Gianini

  • 1I Divisione Medica, Modulo di Endocrinologia, Ospedale Maggiore, Lodi.

Minerva Endocrinologica
|April 29, 1998
PubMed
Summary
This summary is machine-generated.

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This case report details a rare instance of differentiated thyroid cancer causing hyperthyroidism. Early molecular diagnostics can help identify such "hot nodules," improving prognosis and treatment strategies.

Area of Science:

  • Endocrinology
  • Oncology
  • Molecular Biology

Background:

  • Differentiated thyroid cancers are rare, accounting for 1% of all neoplasias.
  • Association with hyperthyroidism is uncommon (7% of cases), and rarer still is cancer causing thyrotoxicosis.

Observation:

  • A 66-year-old male presented with a new goiter, suspected lung cancer, and hyperthyroid symptoms.
  • Fine-needle aspiration biopsy (FNAB) revealed high thyroglobulin, indicating a primary thyroid lesion.
  • I-131 scintiscan confirmed the thyroid as the source of excess thyroid hormones; histology diagnosed papillary carcinoma.

Findings:

  • The patient's hyperthyroidism was directly caused by the papillary thyroid carcinoma.
  • Unlike some cases, thyroid-stimulating auto-antibodies associated with Graves' disease were absent.

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  • An activating mutation in the thyroid hormone receptor (TSH-r) gene was identified in the hyperfunctioning cancer.

    • Implications:

    • This case highlights the importance of investigating "hot nodules" for malignancy, as they may be more common than previously thought.
    • Molecular diagnostics via FNAB can aid in defining the neoplastic nature of hot nodules.
    • Identifying such rare presentations is crucial for accurate prognosis and therapeutic strategy in thyroid cancer.