Vol.99 No.1 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 99 No. 1 January 2006
Functioning Thyroid Papillary Carcinoma: A case report
Satoshi Ohno
(Toyo-oka Hospital)
Norio Yamamoto, Ryo Asato, Shinzo Tanaka and Juichi Ito
(Kyoto University Graduate School of Medicine)
Koichi Omori
(Fukushima Medical University School of Medicine)
Atsuhiro Yoshida
(Shiga Medical Center for Adults)
Yasuyuki Hiratsuka
(Shimada Municipal Hospital)
Malignant tumors among autonomously functioning thyroid nodules are extremely rare. Here we report a case of uncommon functioning thyroid tumor with papillary carcinoma histology that was confused with Graves' disease on preoperative investigation.
A 30-year-old woman presented with anterior neck mass and hyperthyroidism that had persisted for several years. We found a 4 cm elastic hard nodule that occupied most of the right lobe of the thyroid gland and diagnosed the lesion as malignant by fine needle aspiration biopsy. Tc scintigraphy demonstrated a hot nodule only in the right lobe and, in addition, serous TSH binding inhibiting immunoglobulin was negative, both of which were inconsistent with the standard criteria of Graves' disease.
With a diagnosis of functioning thyroid carcinoma, we performed right lobectomy of the thyroid gland and then only one tumor with histopathological diagnosis of papillary carcinoma was found in the right lobe. Postoperatively, euthyroidism was achieved without any anti-thyroid drug. Thus, taking various pre- and post-operative evidence into account, the final diagnosis was functioning thyroid papillary carcinoma. There has been no recurrence or hyperthyroidism for 32 months postoperatively.
Key words : papillary carcinoma, autonomously functioning thyroid nodule, hyperthyroidism, scintigraphy