open access

Vol 69, No 1 (2018)
Case report
Published online: 2017-12-21
Submitted: 2017-02-19
Accepted: 2017-06-19
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Anaplastic thyroid carcinoma with rapid thyrotoxicosis — a case report and the literature review

Jacek Daroszewski, Katarzyna Paczkowska, Aleksandra Jawiarczyk-Przybyłowska, Marek Bolanowski, Michał Jeleń
DOI: 10.5603/EP.a2018.0010
·
Pubmed: 29319130
·
Endokrynologia Polska 2018;69(1):28-31.

open access

Vol 69, No 1 (2018)
Case report
Published online: 2017-12-21
Submitted: 2017-02-19
Accepted: 2017-06-19

Abstract

Introduction: Anaplastic thyroid carcinoma (ATC) is one of the most aggressive human malignancies and constitutes approximately 1.6–5% of the malignant neoplasms of the thyroid gland. ATC usually manifests itself with the local symptoms due to a rapidly enlarging thyroid mass, and as other thyroid cancers, has only seldom been reported to cause thyrotoxicosis. Up to now only 9 cases of ATC with concomitant thyrotoxicosis have been described.

Case report: We report a rare case of a 66-year-old woman, who had had the preexisting large, euthyroid multinodular goiter for almost 50 years. She was consulted by a doctor because of a 4-week history of thyrotoxicosis, symptoms of the congestive heart failure and a rapid increase in the size of the goiter. Thyroid hormone levels were consistent with a hyperthyroid state. The fine-needle aspiration biopsy confirmed a diagnosis of the anaplastic thyroid carcinoma, the small cells variant. The 99m Tc-pertechnetate scintigraphy visualized non-homogenous tracer distribution with hot nodules.

She was given a doxorubicin (20 mg/week) and required the continuous antithyroid treatment. The patient died a one year after the first symptoms of the disease occurred.

Discussion: The association between ATC and a thyrotoxic state is very rare. In most cases, thyrotoxicosis concomitant with ATC was thought to be a result of the destruction of the thyroid follicles by the rapid infiltration with malignant cells, resulting in the leakage of preformed hormones to the circulation. In that case the most probable cause of thyrotoxicosis was the multinodular goiter coexisting with ATC. A simultaneous onset of tumor growth, thyrotoxicosis and a relatively long survival time of our patient is worth to notice and discuss.

Abstract

Introduction: Anaplastic thyroid carcinoma (ATC) is one of the most aggressive human malignancies and constitutes approximately 1.6–5% of the malignant neoplasms of the thyroid gland. ATC usually manifests itself with the local symptoms due to a rapidly enlarging thyroid mass, and as other thyroid cancers, has only seldom been reported to cause thyrotoxicosis. Up to now only 9 cases of ATC with concomitant thyrotoxicosis have been described.

Case report: We report a rare case of a 66-year-old woman, who had had the preexisting large, euthyroid multinodular goiter for almost 50 years. She was consulted by a doctor because of a 4-week history of thyrotoxicosis, symptoms of the congestive heart failure and a rapid increase in the size of the goiter. Thyroid hormone levels were consistent with a hyperthyroid state. The fine-needle aspiration biopsy confirmed a diagnosis of the anaplastic thyroid carcinoma, the small cells variant. The 99m Tc-pertechnetate scintigraphy visualized non-homogenous tracer distribution with hot nodules.

She was given a doxorubicin (20 mg/week) and required the continuous antithyroid treatment. The patient died a one year after the first symptoms of the disease occurred.

Discussion: The association between ATC and a thyrotoxic state is very rare. In most cases, thyrotoxicosis concomitant with ATC was thought to be a result of the destruction of the thyroid follicles by the rapid infiltration with malignant cells, resulting in the leakage of preformed hormones to the circulation. In that case the most probable cause of thyrotoxicosis was the multinodular goiter coexisting with ATC. A simultaneous onset of tumor growth, thyrotoxicosis and a relatively long survival time of our patient is worth to notice and discuss.

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Keywords

anaplastic thyroid carcinoma, thyrotoxicosis

About this article
Title

Anaplastic thyroid carcinoma with rapid thyrotoxicosis — a case report and the literature review

Journal

Endokrynologia Polska

Issue

Vol 69, No 1 (2018)

Pages

28-31

Published online

2017-12-21

DOI

10.5603/EP.a2018.0010

Pubmed

29319130

Bibliographic record

Endokrynologia Polska 2018;69(1):28-31.

Keywords

anaplastic thyroid carcinoma
thyrotoxicosis

Authors

Jacek Daroszewski
Katarzyna Paczkowska
Aleksandra Jawiarczyk-Przybyłowska
Marek Bolanowski
Michał Jeleń

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