Graves’ disease with hyperfunctioning thyroid nodule harboring thyroid carcinoma. Case report and literature review
- 7 February 2020
- journal article
- Published by Publishing House ABV Press in Head and Neck Tumors (HNT)
Abstract
According to the American Thyroid Association’s 2015 guidelines: “Since hyperfunctioning nodules rarely harbor malignancy, if one is found that corresponds to the nodule in question, no cytologic evaluation is necessary”. These findings are based on numerous studies proving the rareness of the combination of functional autonomy and thyroid cancer, and when such casuistry is detected, the non-aggressive course of the malignant process is observed.Rare revealing of malignant nodules functional autonomy can be attributed to several fundamental bases of non-medullary thyroid carcinoma pathogenesis. According to one of the hypotheses of carcinogenesis, dedifferentiation of thyrocytes occurs initially with the loss of the possibility of the sodium-iodine symporter synthesis, and later of the thyroid-stimulating hormone receptor synthesis by the cell, which reduces the hormone production by tumor cells. In addition, hyperthyroidism has a protective feature. It reduces the level of thyroid-stimulating hormone (which causes hypertrophy, hyperplasia of thyrocytes and has an antiapoptotic effect). This protective function is used in practice for suppressive therapy in the postoperative period, which reduces the progression, recurrence and mortality from thyroid cancer. The above circumstances prove the rareness of the clinical observation described below, which deserves additional attention and subsequent discussion.Keywords
This publication has 44 references indexed in Scilit:
- Diagnosis of thyroid neoplasms: state of the art on 2018Endocrine Surgery, 2018
- The Pathology of HyperthyroidismFrontiers in Endocrinology, 2018
- Papillary thyroid cancer in an adolescent with a toxic single nodular goiterProblemy Endokrinologii, 2017
- 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of ThyrotoxicosisThyroid®, 2016
- 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid CancerThyroid®, 2016
- Papillary thyroid microcarcinomaClinical and experimental thyroidology, 2015
- Thyroid Cancer in Patients with HyperthyroidismHormone and Metabolic Research, 2012
- Hyperthyroidism and Other Causes of Thyrotoxicosis: Management Guidelines of the American Thyroid Association and American Association of Clinical EndocrinologistsThyroid®, 2011
- Autonomously functioning thyroid nodule treated with radioactive iodine and later diagnosed as papillary thyroid cancerHormones, 2008
- Hyperfunctioning differentiated thyroid carcinomaJournal of Endocrinological Investigation, 1998