Follicular Variant of Papillary Thyroid Carcinoma Presenting as Toxic Nodule in an Adolescent: Coexistent Polymorphism of the <i>TSHR</i> and <i>Gsα</i> Genes

Ruggeri, Rosaria Maddalena; Campennì, Alfredo; Giovinazzo, Salvatore; Saraceno, Giovanna; Vicchio, Teresa Manuela; Carlotta, Dario; Cucinotta, Maria Paola; Micali, Carmelo; Trimarchi, Francesco; Tuccari, Giovanni; Baldari, Sergio; Benvenga, Salvatore

doi:10.1089/thy.2012.0279

Cited by 24 publications

(17 citation statements)

References 35 publications

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“…Furthermore, all of the seven were papillary thyroid carcinoma, with one of these having the follicular variant subtype 2. We found only two case reports of hyperfunctioning follicular variant papillary thyroid carcinoma 4 5…”

Section: Discussionmentioning

confidence: 77%

Follicular variant of papillary thyroid carcinoma: an unusual cause of thyrotoxicosis

et al. 2015

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SUMMARYThyroid carcinoma presenting as a hyperfunctioning thyroid nodule is rare. A further complexity is added when interpretation of the histopathology itself is not straightforward. We describe a case of a 16-year-old girl presenting with clinical and biochemical evidence of thyrotoxicosis, and a 4 cm thyroid mass. An ultrasound and thyroid uptake scan demonstrated a toxic adenoma. Owing to the nodule size, fine needle aspiration of the thyroid adenoma was performed, which showed findings consistent with toxic adenoma. However, in view of the size of the nodule, a hemithyroidectomy was performed. Histological examination of the thyroid revealed a follicular variant of papillary carcinoma of the thyroid, and the patient underwent completion thyroidectomy. We report on the case and briefly review the available literature relating to the diagnostic challenge of this presentation. BACKGROUND

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Section: Discussionmentioning

confidence: 77%

Follicular variant of papillary thyroid carcinoma: an unusual cause of thyrotoxicosis

et al. 2015

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“…In fact, the risk of a malignant evolution over time is not negligible, as also suggested by the several cases of primary thyroid carcinoma that were recently described in children suffering from HTNs [78][79][80][81].…”

Section: Hyperfunctioning Thyroid Nodulesmentioning

confidence: 96%

Management of hyperthyroidism in children

Luca

Salzano

Zirilli

et al. 2016

Expert Review of Endocrinology & Metabolism

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Treatment of hyperthyroidism in children differs according to its etiology; in particular, the optimal therapy of Graves' disease (GD) remains a matter of debate and there is currently no evidence-based therapeutic strategy that is universally adopted in all the countries. Areas covered: The most recent treatment strategies in the different pediatric conditions which may be associated with hyperthyroidism. We searched PubMed and Cochrane (1990 to 2016) in order to identify articles to include in this review using the following terms: Hyperthyroidism, Childhood, Antithyroid drug therapy, Thyroidectomy, Radioactive iodine. Expert commentary: Although pharmacological therapy represents the first-line approach for GD children, we recommend to individualize, as much as possible, the overall therapeutic approach, with no prejudices towards radical therapies, particularly in the cases with frequent relapses. Clinical and laboratory preferential criteria for an individualized therapeutic approach to GD children are given. Treatment procedures for hyperthyroid children without GD are also discussed.

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“…Notably, however, one of these three patients also harbored thyroid cancer. Additionally, in recent years, there have been several other case reports of incidental detection of hot nodules in children [29][30][31].…”

Section: Thyroid Cancer In Functional Nodulesmentioning

confidence: 99%

Marine-Lenhart syndrome in two adolescents, including one with thyroid cancer: a case series and review of the literature

Sharma

2017

Journal of Pediatric Endocrinology and Metabolism

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Background: The coexistence of functional thyroid nodules and Graves' disease (GD) is a rare condition known as Marine-Lenhart syndrome. Thyroid cancer has been described in several adults, but never in children, with Marine-Lenhart syndrome. This paper discusses the challenges in diagnosis and the unique management of this condition in children, in the context of extant literature. Content: In this case report, two adolescent female patients with Marine-Lenhart syndrome, aged 15 and 16 years, exhibited biochemical evidence of hyperthyroidism, and were found to have unilateral hyperfunctioning thyroid nodules via thyroid scintigraphy. Additionally, both patients showed elevated thyroid-stimulating immunoglobulins (TSI) and increased glandular activity, confirming background GD. Notably, one patient was also diagnosed with intranodular thyroid cancer upon preoperative examination. Both patients were treated via surgical resection. Summary and outlook: Diagnosis of Marine-Lenhart syndrome can be made in patients with functional thyroid nodules and increased glandular activity on thyroid scintigraphy. Standard doses of radioiodine ablation are not effective in the majority of patients and should be avoided due to the increased risk for thyroid cancer, making thyroidectomy the preferred treatment.

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Follicular Variant of Papillary Thyroid Carcinoma Presenting as Toxic Nodule in an Adolescent: Coexistent Polymorphism of the TSHR and Gsα Genes

Abstract: This case demonstrates that the presence of hyperfunctioning thyroid nodule(s) does not rule out cancer and warrants careful evaluation, especially in childhood and adolescence to overlook malignancy.

Cited by 24 publications

References 35 publications

Follicular variant of papillary thyroid carcinoma: an unusual cause of thyrotoxicosis

Follicular variant of papillary thyroid carcinoma: an unusual cause of thyrotoxicosis

Management of hyperthyroidism in children

Marine-Lenhart syndrome in two adolescents, including one with thyroid cancer: a case series and review of the literature

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