并发甲状腺功能亢进和甲状腺乳头状癌

E. Gagliano, G. Sturniolo, A. Querci, A. Milone, D. Paparo, Fabiano, D. Ricciardello, F. Vermiglio
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引用次数: 2

摘要

背景:并发甲状腺癌和甲状腺功能亢进是罕见的,尽管越来越多的报道。甲状腺癌引起的甲状腺功能亢进是非常罕见和具有挑战性的。病例介绍:我们报告了一名35岁的女性,她因心悸恶化,连续12个月不规律地服用丙泊洛尔和地高辛。她来我们的Policlinic大学进行丙泊洛尔药物评估。我们确定了甲状腺功能亢进的特征,并发现了一个没有颈部淋巴结病的左单结节性甲状腺肿。她被转介进行甲状腺检查,提示原发性甲状腺功能亢进和异质性左叶肿大,并有明确的均匀实性肿块。我们重新给她开丙泊洛尔,并建议她用甲巯咪唑进行新的疗程。在政治大学,她还接受了左侧甲状腺叶切除术。切除的肺叶被送去做细胞学检查,发现一个肿瘤结节,其特征提示甲状腺乳头状癌引起甲状腺功能亢进。术后患者临床进展良好,甲状腺功能亢进也有所消退。结论:病史、临床和实验室结果提示甲状腺乳头状癌所致的甲状腺功能亢进。高怀疑指数,及时转诊和反转诊导致这种罕见病例的积极结果。我们提倡对所有甲状腺结节进行系统和仔细的评估。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Concurrent Hyperthyroidism and Papillary Thyroid Cancer
Background: Concurrent thyroid cancer and hyperthyroidism is rare, though increasingly reported. Hyperthyroidism due to thyroid cancer is very rare and challenging. Case presentation: We present a 35-year-old woman who had been on irregular regimen of propanolol and digoxin as treatment for worsening palpitations for 12 months. She came to our Policlinic University for her propanolol medication evaluation. We identified features of hyperthyroidism and found a left uninodular goiter with no cervical lymphadenopathy. She was referred for thyroid assessment which suggested primary hyperthyroidism and an enlarged heterogeneous left lobe with a well-defined homogenous solid mass. We restarted her on propanolol and referred her for a new course with methimazole. At the Policlinic University, she also underwent a left thyroid lobectomy. The resected lobe was sent for cytology evaluation which revealed a neoplastic nodule with features suggestive of a papillary thyroid cancer causing hyperthyroidism. The postoperative clinical progress of the patient was good and a regression of hyperthyroidism was also evidenced. Conclusions: The historical, clinical, and laboratory findings were suggestive of hyperthyroidism due to papillary thyroid cancer. A high index of suspicion, prompt referral, and counter-referral lead to a positive outcome of such a rare case. We advocate for systematic and careful evaluation of all thyroid nodules.
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