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

Abstract

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)

Malignant Pseudothyroiditis after COVID-19 Infection Revealing a Poor-Cellular Variant of a Thyroid Anaplastic Carcinoma

“…If we define MPT as a clinical presentation of SAT revealing infiltration of the thyroid by malignant cells, we can distinguish three categories: (a) MPT revealing a solid cancer, seventeen cases were described in the review of Jonklaas et al [5] most of which are of breast or lung cancer origin (b) MPT revealing hematological malignancies: seven cases were described in the same review, most of which are lymphomas (c) MPT revealing anaplastic carcinoma with 12 cases described in the literature including ten in the publication of Daroszewski [6] and one, published in 2020, by Fatula et al [7].…”

Refractory Thyrotoxicosis in Oropharyngeal Squamous Cell Carcinoma Invading the Thyroid Gland

“…Various studies have reported instances of primary thyroid malignancy leading to hyperthyroidism (1)(2)(3)(4)(5)(6). Thyroid metastases from non-thyroidal malignancy have also reportedly caused hyperthyroidism, most being lung, breast or hematological in origin (7).…”

“…Therefore, we postulate that the mechanism of thyrotoxicosis in our patient could be follicular and stromal disruption of the thyroid parenchyma from local invasion by the OPSCC. The rapid growth of the cancer could cause necrosis of the thyroid follicles resulting in the loss of its integrity in a mechanism analogous to subacute thyroiditis (4,7,14), thereby releasing thyroxine (T4) and triiodothyronine (T3) into the circulation. This was termed "malignant pseudothyroiditis" in the context of primary thyroid carcinoma by Rosen et al (16).…”

New-onset thyrotoxicosis in a patient with anaplastic thyroid carcinoma: a diagnostic challenge

“…Distant metastases are found in 50% of cases at the time of diagnosis ( 1 ). Case reports associated with thyrotoxicosis are rare ( 2 , 3 ).…”