Hot and malignant – a case of invasive papillary carcinoma in hyperthyroid patient with hot nodules. Issue 4 (4th July 2018)

• Record Type: Journal Article
• Authors: Pandey, Ramesh K.; Sharma, Eliza; Roy, Sasmit; Kandel, Saroj; Dahal, Sumit; Hossain, Muhammad Rajib; Schmidt, Marie F.; Shiferaw-Deribe, Zewge
• Is Part Of: Journal of community hospital internal medicine perspectives. Volume 8:Issue 4(2018)
• Page Start: 220
• Page End: 222
• Publication Date: 2018-07-04
• Subjects: Metastasis -- papillary thyroid carcinoma -- hot nodule -- carcinoma of thyroid -- hyperthyroidism; Internal medicine -- Periodicals; Hospitals -- Periodicals; Hospitals, Community; Internal Medicine; Hospitals; Internal medicine; Periodicals; Periodicals; 610
• DOI: 10.1080/20009666.2018.1490139
• Languages: English
• ISSNs: 2000-9666

Abstract

ABSTRACT: Introduction : Malignant thyroid nodules are clinically euthyroid and appear as cold nodules on scintigraphy. Malignancy in hyper-functioning thyroid nodule is rare. Case report : A 48-year-old male with painless swelling on the right side of his neck for the last 4 months complained of feeling hot all the time, sweating and unintentionally losing about 20 pounds. On physical examination, there was a 3-cm mobile, non-tender mass on the right supra-clavicular area biopsy of which was consistent with metastatic papillary carcinoma of thyroid. Neck imaging showed a cystic mass in the right supra-clavicular fossa region, bilateral neck adenopathy and multiple thyroid nodules. Subsequent thyroid radionuclide scans showed three hyper-functioning nodules, which were later demonstrated to be a follicular variant of papillary microcarcinoma. He was treated with total thyroidectomy followed by radioactive iodine thyroid ablation therapy. Conclusion : Physicians need to be aware and vigilant for the possibilities of malignancy in a hyper-functioning thyroid nodule when evaluating any thyroid nodule.