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- Title
A Case of simultaneous occurrence of Marine--Lenhart syndrome and a papillary thyroid microcarcinoma.
- Authors
Scherer, Thomas; Wohlschlaeger-Krenn, Evelyne; Bayerle-Eder, Michaela; Passler, Christian; Reiner-Concin, Angelika; Krebs, Michael; Gessl, Alois
- Abstract
Background: Marine-Lenhart syndrome is defined as the co-occurrence of Graves' disease and functional nodules. The vast majority of autonomous adenomas are benign, whereas functional thyroid carcinomas are considered to be rare. Here, we describe a case of simultaneous occurrence of Marine-Lenhart syndrome and a papillary microcarcinoma embedded in a functional nodule. Case presentation: A 55 year-old, caucasian man presented with overt hyperthyroidism (thyrotropin (TSH) <0.01 µIU/L; free thyroxine (FT4) 3.03 ng/dL), negative thyroid peroxidase and thyroglobulin autoantibodies, but elevated thyroid stimulating hormone receptor antibodies (TSH-RAb 2.6 IU/L). Ultrasound showed a highly vascularized hypoechoic nodule (1.1 × 0.9 × 2 cm) in the right lobe, which projected onto a hot area detected in the 99mtechnetium thyroid nuclear scan. Overall uptake was increased (4.29%), while the left lobe showed lower tracer uptake with no visible background-activity, supporting the notion that both Graves' disease and a toxic adenoma were present. After normal thyroid function was reinstalled with methimazole, the patient underwent thyroidectomy. Histological work up revealed a unifocal papillary microcarcinoma (9 mm, pT1a, R0), positively tested for the BRAF V600E mutation, embedded into the hyperfunctional nodular goiter. Conclusions: Neither the finding of an autonomously functioning thyroid nodule nor the presence of Graves' disease rule out papillary thyroid carcinoma.
- Subjects
CANCER chemotherapy; CANCER diagnosis; CANCER treatment; HYPERTHYROIDISM; GRAVES' disease; THYROID antagonists; THYROID gland; THYROID gland tumors; THYROIDECTOMY; THYROXINE; DIAGNOSIS; THERAPEUTICS
- Publication
BMC Endocrine Disorders, 2013, Vol 13, Issue 1, p16
- ISSN
1472-6823
- Publication type
Article
- DOI
10.1186/1472-6823-13-16