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 131 I scintigraphy has detected a "hot" nodule and a partial suppression of 131 I 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 131 I. 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. A associação de câncer diferenciado da tiróide com nódulo funcionante é muito baixa. Apresentamos uma mulher de 39 anos com carcinoma papilar em nódulo autônomo funcionante da tiróide. O nódulo ocupava todo o lobo direito e o estudo cintilográfico com I 131 detectou um nódulo quente e supressão parcial da captação de I 131 pelo lobo esquerdo. Os níveis de TSH (RIE) eram indetectáveis (<1,0µUI/mL), mas os de T3 (190ng/dl) e T4 total (8,5µg/dl) normais. Submetida à tiroidectomia parcial, encontrou-se nódulo adenomatoso com um pequeno núcleo central (7mm) com carcinoma papilar. A pesquisa de corpo inteiro mostrou somente captação residual da tiróide e a paciente foi tratada com uma dose de 100mCi de I 131 . A paciente está recebendo terapia substitutiva com 150µg de L-tiroxina e 12 anos após a cirurgia não apresenta qualquer sinal de recorrência tumoral. Em conclusão: a paciente descrita confirma outros casos publicados de que a presença de um nódulo "quente" da tiróide não exclui a possibilidade da ocorrência de um carcinoma bem diferenciado. Descritores: Carcinoma papilar; Doença de Graves; Nódulo quente; Carcinoma da tiróide; Nódulo da tiróide T HE ASSOCIATION OF THYROID carcinoma and hyperthyroidism is presently considered more frequent than it was in the past (1). The most frequent association of thyroid carcinoma is with "hot" nodules, with apresentação de casos
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