- Author:
Ji Hyun KIM
1
;
Gyeong Jae NA
;
Ki Won KIM
;
Hee Ja KO
;
Sung Wan JEON
;
Yeo Joo KIM
;
Sang Jin KIM
;
Hyeun Duk JO
;
Chang Jin KIM
Author Information
- Publication Type:Case Report
- Keywords: Thyroid nodule; Papillary thyroid cancer
- MeSH: Autoantibodies; Biopsy, Fine-Needle; Carcinoma; Female; Humans; Iodine; Middle Aged; Thyroid Function Tests; Thyroid Gland; Thyroid Neoplasms; Thyroid Nodule; Thyroidectomy; Thyrotoxicosis; Weight Loss
- From:Endocrinology and Metabolism 2012;27(1):59-62
- CountryRepublic of Korea
- Language:English
- Abstract: 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 x 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.