Papillary carcinoma of the thyroid in an autonomously functioning nodule

• Autor(a) principal: Calegaro,José Ulisses M.
• Data de Publicação: 2003
• Outros Autores: Dias,Maria Stella Oliveira, Bae,Sung Hoon, Moraes,Sioeme da Silva, Gomes,Enio de Freitas, Casulari,Luiz Augusto
• Tipo de documento: Relatório
• Idioma: eng
• Título da fonte: Arquivos Brasileiros de Endocrinologia & Metabologia (Online)
• Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27302003000600018
• topic: Carcinoma; Papillary; Graves' disease; Hot nodule; Thyroid carcinoma; Thyroid nodule

The association of differentiated thyroid cancer and a functioning nodule is very low. We report on a case of papillary carcinoma in an autonomously functioning thyroid nodule in a 39 year-old female patient. The nodule extended to the whole right lobe and 131I scintigraphy has detected a ''hot'' nodule and a partial suppression of131I uptake in the left lobe. Serum TSH levels (RIA) were undetectable (<1.0µUI/mL), but total T3 (190ng/dL) and T4 (8.5µg/dL) were normal. The patient underwent a partial thyroidectomy and an adenomatous nodule was found with a small central nucleus (7mm) hosting a papillary carcinoma. Whole body scans detected only residual thyroid uptake and the patient was subsequently treated with 100mCi of 131I. The patient has been on replacement therapy with 150µg of L-thyroxine and free of tumor recurrence for 12 years after surgery. In conclusion: the present report confirms other published cases in which the presence of a ''hot'' thyroid nodule does not exclude the concomitance of a well-differentiated thyroid carcinoma.