Anaplastic Thyroid Cancer and Hyperthyroidism

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 nonhomogenous 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. (Endokrynol Pol 2018; 69 (1): 28-31)

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“…To our knowledge, only nine other cases have been described in the literature [7][8][9][10][11][12][13][14][15].…”

Section: Discussionmentioning

confidence: 99%

Anaplastyczny rak tarczycy z gwałtowną tyreotoksykozą — opis przypadku i przegląd literatury

Daroszewski

Paczkowska

Jawiarczyk-Przybyłowska

et al. 2018

Endokrynologia Polska

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“…Destruction of the thyroid gland itself by trauma after an accident,14 due to metastasis to the thyroid gland from another primary tumour15 or due to destructive anaplastic thyroid cancer16 was reported to result in thyrotoxicosis.…”

Section: Discussionmentioning

confidence: 99%

Recurrent thyroid storm induced by heretofore unrecognised causes in a patient with thyroid cancer

Raef¹,

Dahhan

Ahmed

et al. 2009

Case Reports

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An unusual encounter of a thyroid storm, on two separate occasions, is reported in a patient with metastatic differentiated thyroid cancer following initially direct trauma to, and later tumour embolisation of, a metastatic skeletal lesion. Shortly after a fall, our patient presented with pain and swelling in the right shoulder, high fever, change in mental status, anorexia, nausea and vomiting, tachycardia and dehydration. The laboratory tests were consistent with hyperthyroidism. As the patient improved, arterial embolisation of the large right humerus metastasis was performed to decrease the tumour burden. The patient, however, developed a similar clinical and biochemical picture to that at her presentation, with a very high free thyroxine (T(4)) level, a few days after successful embolisation. Treatment of the thyroid storm was initiated and the patient eventually improved. Awareness of such occurrences is helpful in early diagnosis and effective management of this potentially fatal complication.

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“…9 As the clinical presentation of this disease is similar to that in thyroiditis, in 1978 Rosen et al 14 named this condition "malignant pseudothyroiditis." 9 Our patient became euthyroid 3 weeks after presentation and antithyroid drug administration as a result of the progress of the disease, not the applied therapy. 10 The tumor destruction of normal thyroid tissue and the consequent development of hyperthyroidism in patients with ATC are also verified by pathohistologic examination.…”

Section: Discussionmentioning

confidence: 99%

“…Despite multimodal therapeutic approaches (surgery, radiotherapy, and chemotherapy), prognosis is still poor with mean survival between 3 and 6 months. [3][4][5][6][7][8][9][10][11][12] In our Center, ATC was diagnosed in 126 patients in the period between 1993 and 2005. It accounts for 2% of all thyroid malignancies.…”

Section: Learning Objectivesmentioning

confidence: 99%

Hyperthyroidism in a Patient With Anaplastic Thyroid Cancer

Živaljević¹,

Diklić²,

Krgović³

et al. 2009

The Endocrinologist

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Anaplastic thyroid cancer (ATC) is one of the most lethal tumors in human medicine; it is characterized by aggressive local invasion and rapid appearance of distant metastases. Tumor compression on surrounding structures in the neck results in symptoms which dominate the clinical presentation. Hyperthyroidism is an extremely rare clinical feature in ATC which is the consequence of normal thyroid follicle destruction caused by tumor invasion. When the tissue destruction is complete, the hyperthyroid phase is followed by the hypothyroid phase of the disease. Such clinical presentation resembles various thyroiditises, thus the name "malignant pseudothyroiditis" or "anaplastic pseudothyroiditis." This is a case report of a 67-year-old man, with concurrent development of ATC and clinical thyrotoxicosis. Despite administration of the antithyroid drugs and ␤-blockers, surgical tumor reduction and adjuvant radiotherapy, the patient died 5 months after the onset of the disease. The literature referring to previous cases of ATC with thyrotoxicosis is reviewed.

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Anaplastic Thyroid Cancer and Hyperthyroidism

Cited by 10 publications

References 26 publications

Anaplastyczny rak tarczycy z gwałtowną tyreotoksykozą — opis przypadku i przegląd literatury

Anaplastyczny rak tarczycy z gwałtowną tyreotoksykozą — opis przypadku i przegląd literatury

Recurrent thyroid storm induced by heretofore unrecognised causes in a patient with thyroid cancer

Hyperthyroidism in a Patient With Anaplastic Thyroid Cancer

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