Primary Thyroid Carcinoma and Thyrotoxicosis

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

Kumar

Blanchon

et al. 2005

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We report a rare case of thyrotoxicosis in a patient with anaplastic thyroid cancer. A 65-yr-old male presented with a 2-d history of rapidly enlarging neck mass and back pain. Physical examination revealed a large, hard thyroid mass and resting tachycardia. He did not have any symptoms suggestive of airway compression at presentation. Thyroid hormone levels were consistent with a hyperthyroid state. CT scan of the neck and thorax showed a heterogeneous mass replacing the thyroid, bilateral pulmonary nodules, and a metastasis with pathological fracture at the level of T-8. Technetium-pertechnetate scan failed to show any uptake in the region of the thyroid. Fine needle aspiration of the thyroid revealed anaplastic thyroid cancer. The patient was started on steroids and radiation therapy of his spine lesion. Brief surgical exploration of the thyroid revealed extensive local infiltration of adjacent neck tissues and marked tumor necrosis. Immunohistochemical stains of the tumor were positive for p53, thyroglobulin, and thyroid transcription factor-1. The tumor had an extremely aggressive course and the patient died of asphyxiation from severe airway compromise 11 d after his initial presentation.

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Primary Thyroid Carcinoma and Thyrotoxicosis

Cited by 3 publications

References 14 publications

Thyrotoxicosis revealing metastases of unrecognized thyroid cancer: a report on two cases

Thyrotoxicosis revealing metastases of unrecognized thyroid cancer: a report on two cases

Hyperthyroidism in a Patient With Anaplastic Thyroid Cancer

Anaplastic Thyroid Cancer and Hyperthyroidism

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