Anaplastic Thyroid Cancer with Transient Thyrotoxicosis: Case Report and Literature Review

Alagöl, Faruk; Tanakol, Refik; Boztepe, Harika; Kapran, Yersu; Terzioğlu, Tarık; Dizdaroğlu, Ferhunde

doi:10.1089/thy.1999.9.1029

Cited by 31 publications

(23 citation statements)

References 16 publications

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“…It was previously postulated that cancer antigens of malignant cells invading thyroid tissue may trigger cytokine-induced immune mechanisms and cytotoxicity against thyrocytes, leading to silent thyroiditis [8,11]. Thyroid destruction and release of thyroid autoantigen may trigger autoimmunity in long-term follow-up.…”

Section: Discussionmentioning

confidence: 99%

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Thyroid metastasis of endometrial carcinosarcoma associated with Graves' disease

Mete¹,

Özbey²,

Erbil³

et al. 2007

Gynecological Endocrinology

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A 54-year-old woman who had undergone total abdominal hysterectomy and bilateral adnexial resection because of endometrial carcinosarcoma presented with thyrotoxicosis, rapidly enlarging neck mass, right cervical tenderness to the ears, palpitation, swelling and heat intolerance, 3 years after the operation. Her serum thyroid hormone levels confirmed hyperthyroidism. Triiodothyronine/thyroxine ratio was 18. The thyroid antibodies were markedly elevated. A thyroid scan showed a cold area corresponding to the thyroid nodule, with high radioiodine uptake in the remaining thyroid tissue. Antithyroid drugs were started to control the hyperthyroidism. In our patient, who had a history of malignancy, the rapidly enlarging neck mass was considered as metastasis to the thyroid gland. The patient underwent bilateral total thyroidectomy. Histopathological examination demonstrated findings compatible with Graves' disease on the left and a carcinosarcoma metastasis on the right thyroid lobe. We suggest that both destructive thyroiditis and Graves' disease contributed to our patient's thyrotoxicosis. Metastatic thyroid carcinoma and destructive thyroiditis should be considered in patients with rapidly enlarging neck mass and a prior history of visceral malignancy.

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Section: Discussionmentioning

confidence: 99%

“…Destruction-induced thyrotoxicosis is also described in patients with anaplastic thyroid carcinoma (i.e. anaplastic pseudothyroiditis) and malignant lymphoma [8,9]. The first report of a patient presenting thyrotoxicosis due to anaplastic thyroid carcinoma was in 1967 by Mangla and colleagues [10].…”

Section: Introductionmentioning

confidence: 99%

Thyroid metastasis of endometrial carcinosarcoma associated with Graves' disease

Mete¹,

Özbey²,

Erbil³

et al. 2007

Gynecological Endocrinology

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“…To our knowledge, only nine other cases have been described in the literature [7][8][9][10][11][12][13][14][15].…”

Section: Discussionmentioning

confidence: 99%

“…It is also relevant that this treatment was very effective to control symptoms of the congestive heart failure and it was necessary to continue the therapy within the whole period of the follow-up. In the literature, we found only one case report of a patient who had ATC and coexisting thyrotoxicosis most likely caused by the multinodular goiter [9].…”

Section: Discussionmentioning

confidence: 99%

Anaplastyczny rak tarczycy z gwałtowną tyreotoksykozą — opis przypadku i przegląd literatury

Daroszewski

Paczkowska

Jawiarczyk-Przybyłowska

et al. 2018

Endokrynologia Polska

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Introduction: Anaplastic thyroid carcinoma (ATC) is one of the most aggressive human malignancies and constitutes approximately 1.6-5% of the malignant neoplasms of the thyroid gland. ATC usually manifests itself with the local symptoms due to a rapidly enlarging thyroid mass, and as other thyroid cancers, has only seldom been reported to cause thyrotoxicosis. Up to now only 9 cases of ATC with concomitant thyrotoxicosis have been described. Case report: We report a rare case of a 66-year-old woman, who had had the preexisting large, euthyroid multinodular goiter for almost 50 years. She was consulted by a doctor because of a 4-week history of thyrotoxicosis, symptoms of the congestive heart failure and a rapid increase in the size of the goiter. Thyroid hormone levels were consistent with a hyperthyroid state. The fine-needle aspiration biopsy confirmed a diagnosis of the anaplastic thyroid carcinoma, the small cells variant. The 99m Tc-pertechnetate scintigraphy visualized nonhomogenous tracer distribution with hot nodules. She was given a doxorubicin (20 mg/week) and required the continuous antithyroid treatment. The patient died a one year after the first symptoms of the disease occurred. Discussion: The association between ATC and a thyrotoxic state is very rare. In most cases, thyrotoxicosis concomitant with ATC was thought to be a result of the destruction of the thyroid follicles by the rapid infiltration with malignant cells, resulting in the leakage of preformed hormones to the circulation. In that case the most probable cause of thyrotoxicosis was the multinodular goiter coexisting with ATC. A simultaneous onset of tumor growth, thyrotoxicosis and a relatively long survival time of our patient is worth to notice and discuss. (Endokrynol Pol 2018; 69 (1): 28-31)

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“…In most described cases, thyrotoxicosis results from the destruction of normal thyroid follicles by the rapidly infiltrating tumor cells, releasing preformed hormones into the circulation [18,19,20]. Basaria et al described this condition as anaplastic pseudothyroiditis [21].…”

Section: Discussionmentioning

confidence: 99%

Anaplastic Carcinoma and Toxic Multinodular Goiter: An Unusual Presentation

Marcelino

Marques

Lopes³

et al. 2014

Eur Thyroid J

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A 70-year-old male was referred with hyperthyroidism and multinodular goiter (MNG). Thyroid ultrasonography showed 2 nodules, one in the isthmus and the other in the left lobe, 51 and 38 mm in diameter, respectively. Neck CT showed a large MNG, thyroid scintigraphy showed increased uptake in the nodule in the left lobe, and fine-needle aspiration biopsy showed a benign cytology of the nodule in the isthmus. The patient declined surgery and was treated with methimazole. After being lost to follow-up for 3 years, the patient returned with complaints of dyspnea, dysphagia, and hoarseness; he was still hyperthyroid. Cervical CT showed a large mass in the isthmus and left lobe with invasion of surrounding tissues, the trachea, the esophagus, and the recurrent laryngeal nerve. Bronchoscopy showed extensive infiltration and compression of the trachea to 20% of its caliber. A tracheal biopsy revealed an anaplastic thyroid carcinoma. The tumor was considered unresectable, and radiotherapy was given. One month later, the patient died. The association between a toxic thyroid nodule and anaplastic thyroid carcinoma has apparently not been reported so far.

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Anaplastic Thyroid Cancer with Transient Thyrotoxicosis: Case Report and Literature Review

Cited by 31 publications

References 16 publications

Thyroid metastasis of endometrial carcinosarcoma associated with Graves' disease

Thyroid metastasis of endometrial carcinosarcoma associated with Graves' disease

Anaplastyczny rak tarczycy z gwałtowną tyreotoksykozą — opis przypadku i przegląd literatury

Anaplastic Carcinoma and Toxic Multinodular Goiter: An Unusual Presentation

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