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KMID : 0356620120270010059
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Journal of Korean Society of Endocrinology
2012 Volume.27 No. 1 p.59 ~ p.62
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Papillary Thyroid Carcinoma Manifesting as an Autonomously Functioning Thyroid Nodule
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Kim Ji-Hyun
Na Gyeong-Jae
Kim Ki-Won
Ko Hee-Ja
Chun Sung-Wan
Kim Yeo-Joo
Kim Sang-Jin
CHo Hyun-Deuk
Kim Chang-Jin
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Abstract
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Hyperfunctioning thyroid carcinoma is very rare. Hence, radionuclide imaging of thyroid hot nodules usually suggests a benign tumor, and less than 4% of cases have been reported as malignant. We would like to present a case of a hyperfunctioning papillary thyroid carcinoma that was initially treated with radioactive iodine. A 58-year-old woman was referred to our hospital for palpable thyroid nodule and a 5-kg weight loss within 6 months. Thyroid function test revealed thyrotoxicosis, and thyroid autoantibodies were absent. 99mTc thyroid scintigraphy showed a 2 × 2 cm-sized hyperactive hot nodule at the left lobe. Despite radioactive iodine treatment with a dose of 10 mCi 131I, thyroid function did not improve. Fine needle aspiration revealed papillary thyroid cancer. The patient underwent total thyroidectomy. Although clinical features and thyroid scans suggest a benign nodule, the possibility of malignancy should not be ruled out. Malignant thyroid hot nodules are rare; however, its possibility should be taken into account. Therefore, we suggest that ruling out malignancy by existing diagnostic guidelines can misdiagnose even a typical case with benign features. As thyroid nodule detection is getting sensitive and accurate, we present this case to discuss whether additional diagnostic approaches would be necessary for thyroid nodules.
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KEYWORD
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Thyroid nodule, Papillary thyroid cancer
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