Metastatic thyroid carcinoma provoking hyperthyroidism, with elevated circulating thyrostimulators

Valenta, Lubomir J.; Lemarchand-Béraud, T; Nĕmec, J; Griessen, M; Bednár, J

doi:10.1016/0002-9343(70)90100-2

Cited by 38 publications

(15 citation statements)

References 11 publications

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“…The basis for this assump¬ tion is reports about patients with metastasizing thyroid carcinoma and hyperthyroidism whose serum was found to contain thyroid-stimulating immunoglobulins as in Graves' disease (29)(30)(31). However, it has not as yet been directly proven that IgG from patients with immunohyperthyroidism and differentiated thyroid carcinoma can stimulate the growth of thyroid carcinoma cells (28).…”

Section: Discussionmentioning

confidence: 99%

Hyperthyroidism and thyroid carcinoma

Ahuja

Ernst²

1991

Acta Endocrinologica

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Twenty-two of 251 patients with differentiated thyroid carcinoma suffered from or had a history of hyperthyroidism. They were hyperthyroid with a diffuse goitre (N=4), a diffuse goitre with a cold nodule (N= 10), a multinodular goitre (N=6), and an autonomous adenoma (N=2). Among the 22 patients, more than one fourth had an occult thyroid carcinoma with a diameter of 1 cm or less, those with the papillary tumour types, less frequently had lymph node metastases than the total group of patients with papillary carcinomas (13.3 vs 35.6%). The clinical courses of the 22 patients resembled those of the other thyroid carcinoma patients whose age and initial findings were comparable. In 643 patients who underwent surgery for hyperthyroidism the incidence of thyroid carcinoma was 2.3%. The increase in coincidence of hyperthyroidism and thyroid carcinoma repeatedly reported in recent years is probably ascribable primarily to extensive and improved diagnostics and not to a direct connection between hyperthyroidism and development of thyroid carcinoma. On the other hand, our findings do confirm that, even in the presence of hyperthyroidism, all thyroid nodules require careful diagnostics for exclusion of malignancy.Opinions differ as to whether a connection exists between hyperthyroidism and thyroid carcinoma. In 1937, Means (1) still considered hyperthyroid¬ ism to be an "insurance against cancer of the thy¬ roid". This assumption was questioned in the early fifties (2,3), and, by the mid-sixties, a connection was even seen between hyperthyroidism and thy¬ roid carcinoma (4). The carcinoma incidence was between 0.2 and 0.5% in the large investigation series of Beahrs et al. (2;3029 patients with Graves' disease), Sokal (3; 13621 patients with hyperthy¬ roidism) and the prospective study of Dobyns et al.

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Section: Discussionmentioning

confidence: 99%

Hyperthyroidism and thyroid carcinoma

Ahuja

Ernst²

1991

Acta Endocrinologica

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“…While the TSI was persistently elevated, a rising serum TG pattern was detected, probably as consequence of tumor tissue enlargement. Snow et al (12) and Valenta et al (13) have reported very similar cases except that their patients were thyrotoxic. Steffensen et al (9) speculated that the differentiated aggressive metastatic thyroid neoplasm could have initiated the autoimmune disorder causing TSI production.…”

Section: Case Reportmentioning

confidence: 78%

Development of Graves' Disease Nine Years After Total Thyroidectomy Due to Follicular Carcinoma of the Thyroid

Katz¹,

Garcia²,

Nièpomniszcze³

1997

Thyroid

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We report a 49-year-old woman with Marfan syndrome who underwent total thyroidectomy for follicular carcinoma. The patient was given 100 mCi of radioactive iodine (131I) followed by levothyroxine (LT4) 0.2 mg/day after surgery. The subsequent five total body scans were negative and thyroglobulin (TG) measurements ranged between undetectable levels to 12 ng/mL. Nine years after thyroidectomy the patient developed bilateral exophthalmos with markedly positive thyroid-stimulating immunoglobulins (TSI), indicating the presence of Graves' disease. TG levels increased and concurrently pulmonary metastases that did not concentrate radioiodine at tracer doses, were diagnosed. Due to these metastatic lesions, the patient received a therapeutic dose of 150 mCi of 131I 1 month after LT4 withdrawal, and a total body scan was made 10 days later. Slight uptake of 131I was found in the right side of the neck, whereas predominant uptake occurred in the right lung base. We suggest that the elevated TSI played a role in the growth of metastases.

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“…Deux équipes [16,30] ont montré que ces anticorps pouvaient stimuler in vitro la croissance et le méta-bolisme des cellules tumorales thyroïdiennes par un méca-nisme proche de celui observé dans la maladie de Basedow. Certains auteurs [16,44] suggèrent, chez les patients présen-tant des TSA circulants et chez qui la maladie progresse malgré l' 131 I, de réaliser une corticothérapie à forte dose à visée immunosuppressive.…”

Section: Physiopathologieunclassified

“…Les caractéristiques cliniques et évolutives des cancers avec métastases sécrétantes peuvent être dégagées des 47 cas cliniques certains d'hyperthyroïdie par métastases sécrétantes de cancer thyroïdien, recensés dans la littérature médicale entre 1946 et 2005 [1, [4][5][6][7][8][10][11][12][14][15][16][17][18][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][38][39][40][41][43][44][45][46][47]. Nous n'avons retenu que les observations dans lesquelles l'hyperthyroïdie pouvait être attribuée de façon formelle aux métastases, soit parce que les patients avaient bénéficié d'une thyroïdecto-mie totale auparavant, soit parce que la captation cervicale de l'iode était inférieure à 5 %.…”

Section: Caractéristiques Cliniquesunclassified