GRAVES' DISEASE IN ECTOPIC THYROID TISSUE: A SCOPING REVIEW AND A CASE STUDY.

IF 4.3 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

European Thyroid Journal Pub Date : 2025-10-03 DOI:10.1530/ETJ-25-0135

Annick Van den Bruel, Pieter Drieskens, Helena Van Haecke, Frank De Geeter, Tatjana Sajevets, Maximilian Luffy, Arno Schad, George J Kahaly

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引用次数: 0

Abstract

Background: Persistent Graves' disease (GD) after total thyroidectomy is sporadic and may be explained by incomplete total thyroidectomy, GD in ectopic thyroid tissue (ETT) or struma ovarii.

Methods: We present a novel case of ectopic GD in a giant paracardiac mass, including an in-depth histologic exam. We searched the Pubmed database on GD in ETT.

Results: A 34-year-old woman presented with severe thyrotoxicosis, 4 months after total thyroidectomy, and 6 weeks after cessation of levothyroxine substitution. Persistently high thyrotropin receptor antibodies (TSH-R-Ab) (27 IU/l, normal <1.5 IU/l) and thyroglobulin > 5000 µg/l (normal <77 µg/l) suggested GD in ETT. A 99mTc-pertechnetate SPECT/CT scan showed uptake in a paracardiac mass. After surgical removal of the 13 cm paracardiac mass, euthyroidism was achieved. Histology was typically remarkable for a Graves' pattern in the ETT as opposed to a nodular pattern in the eutopic thyroid. The additional scoping review encompasses 29 reported ETT cases of which only 11 were in the mediastinum. Graves' eye disease was present in 11 / 29 subjects.

Conclusion: This is the first report showing a markedly different histology between the thyroid and the ectopic tissue. Persistent systemic severe GD post-thyroidectomy led to the detection of a giant paracardiac ectopic thyroid. GD in ETT is rare and presents a diagnostic challenge.

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异位甲状腺组织中的Graves病：范围回顾和个案研究

背景：甲状腺全切除术后持续性Graves病（GD）是散发性的，可能与甲状腺全切除术不完全、甲状腺异位组织（ETT）或卵巢肿大有关。方法：我们提出一个新的病例异位GD在一个巨大的心旁肿块，包括深入的组织学检查。我们在Pubmed数据库中检索了ETT中的GD。结果：一名34岁女性在全甲状腺切除术后4个月，停止左旋甲状腺素替代治疗后6周出现严重甲状腺毒症。持续高促甲状腺激素受体抗体（TSH-R-Ab）（27 IU/l，正常5000µg/l）结论：这是首次报道甲状腺和异位组织之间有明显不同的组织学。甲状腺切除术后持续系统性严重GD导致发现巨大的心旁异位甲状腺。ETT的GD是罕见的，给诊断带来了挑战。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Thyroid Journal Medicine-Endocrinology, Diabetes and Metabolism

CiteScore

6.70

自引率

2.10%

发文量

156

期刊介绍： The ''European Thyroid Journal'' publishes papers reporting original research in basic, translational and clinical thyroidology. Original contributions cover all aspects of the field, from molecular and cellular biology to immunology and biochemistry, from physiology to pathology, and from pediatric to adult thyroid diseases with a special focus on thyroid cancer. Readers also benefit from reviews by noted experts, which highlight especially active areas of current research. The journal will further publish formal guidelines in the field, produced and endorsed by the European Thyroid Association.