An Autonomously Functioning Thyroid Carcinoma Associated with ...
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An Autonomously Functioning Thyroid Carcinoma Associated with ...
A tumor mass measuring. 1.5 x 1.0 cm was found in the resected thyroid gland. Histologi cally, the tumor was composed of papillary growth of follicular cells with ...
Departments ofNuclear Medicine, Neurology and Surgery (II), Pathology Section, Kanazawa University Hospital, Kanazawa, Japan
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A 39-yr-old man with an autonomouslyfunctioningthyroid carcinoma is presented. Only 17 similar cases have been reported in the literature. The patient had unilateral Graves' ophthalmopathy. He was euthyroid as reflected by normal TSH concentration,whereas the resultsof a T3 suppression test established the presence ofautonomous thyroid function. A thyroidscan with revealeda hot nodulecorresponding to the locationof a papillarycarcinomaand remainedsub stantially unchanged after T3 administration. The hyperfunc tion of the carcinoma itself was clearly confirmed by the intense concentration of 1311within the tumor on microauto radiograms. While a hot nodule on radioiodine scan is unlikely to be malignant,the possibilityof carcinomashouldnot be overlooked.
cervical node enlargement. Left proptosis with retraction of the upper eyelid was observed, and, on exophthalmic measurements, the left was 25 mm and the right was 18 mm. Routine laboratory data showed no abnormality. Thyroid hormone assays were normal: free T3 (RIA) 3.49 pg/mi (normal 2.25—5.36);T3 (RIA) 91.3 ng/ml (normal80—190); freeT4 (RIA) 0.94 ng/dl (normal 0.7—2.1);T4 (EIA) 6.2 @tg/dl(normal 4.6—1 1.0); TSH (EIA) 0.38 i@U/ml(normal 0.27—6.00).Furthermore, TSH response to 500 @ig TRH injection was normal (TSH max. was 13.22 @U/mlat 30 mm). TSH receptor antibody (TRAb) measured using Smith's kit was slightly elevated(an inhibition rate of 13%, normal —10% to +10%). Thyroglobulin (Tg) antibody was negative and Tg (RIA) was increased (9 1.7 ng/ml, normal
