Papillary carcinoma thyroid metastases presenting as thyrotoxicosis post thyroidectomy - A case report

Abstract

Thyrotoxicosis can occur in the setting of differentiated thyroid cancer due to functioning metastases. Here, we report a case of a 63 year old woman with papillary carcinoma thyroid who underwent total thyroidectomy and defaulted for further scheduled treatment with high dose radioactive iodine therapy. 2 years after total thyroidectomy, she presented with signs and symptoms of thyrotoxicosis and a scalp swelling on the right side of frontal region. Excision biopsy revealed metastatic deposits of papillary carcinoma thyroid. Even after withdrawal of thyroxine, her serum thyrotropin did not rise and thyroglobulin levels were high, raising the suspicion of high volume tumour burden. I-131 whole body scan was done and it revealed radio iodine avid cervical lymph nodes along with functioning lung and skeletal metastases.

Thyroglobulin as a Rapid and Cost-Effective Biomarker for Diagnosis of Thyroid Carcinoma Brain Metastasis: A Case Report of a Patient with Metastatic Hurthle Cell Thyroid Carcinoma

“…Moreover, we described a case of an 81-year-old patient with a history of metastatic papillary thyroid carcinoma, a pure oncotic variant with a persistent biochemical disease after initial treatment, who eventually developed brain metastasis. As expected in other cases throughout the literature, brain metastasis was late and secondary to lung metastasis [ 9 , 11 , 13 , 17 , 19 , 21 ]. However, metastatic lung disease was not proven due to a lack of biopsy.…”

“…However, reported cases of metastases to the pituitary gland and choroid plexus or ventricular system have also been reported [ 11 , 15 , 16 ]. Although rare, PTC metastasis to the head and neck has been reported [ 17 ].…”