Ucan Bekir, Delibasi Tuncay, Cakal Erman, Arslan Muyesser Sayki, Bozkurt Nujen Colak, Demirci Taner, Ozbek Mustafa, Sahin Mustafa
Department of Endocrinology and Metabolism, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
Department of Endocrinology and Metabolism, School of Medicine, Ankara University, Ankara, Turkey.
Arq Bras Endocrinol Metabol. 2014 Nov;58(8):851-4. doi: 10.1590/0004-2730000003222. Epub 2014 Nov 1.
Subacute thyroiditis (SAT) association with thyroid carcinoma has been rarely reported in the literature. We present a patient with SAT and papillary thyroid cancer that was suspected by ultrasonographic evaluation (US) following SAT treatment. A fifty-four-year old female patient referred to our department due to tachycardia, jitteriness and pain in cervical region for the past one month. SAT diagnosis was established by physical examination, laboratory and ultrasonographic findings. After treatment, control thyroid US revealed regression of the hypoechogenic regions seen in both lobes, and a previously unreported hypoechogenic lesion with microcalcification focus that had irregular borders and was not clearly separated from the surrounding parenchyma located in the posterior aspect of the lobe (Elasto score: 4, Strain index: 7.08). Fine needle aspiration biopsy was taken from this nodule; cytology was assessed to be compatible with papillary thyroid carcinoma. Postsurgical pathology evaluation showed a papillary microcarcinoma. SAT may produce ultrasound changes that obscure the coexistence of papillary carcinoma. We recommend that patients with SAT have ultrasonography after they recover. Hypoechogenic regions bigger than 1 cm that are present in the follow-up post-therapy US should be assessed by biopsy.
亚急性甲状腺炎（SAT）与甲状腺癌的关联在文献中鲜有报道。我们报告一例在SAT治疗后经超声评估（US）怀疑患有SAT和甲状腺乳头状癌的患者。一名54岁女性患者因过去一个月出现心动过速、烦躁不安和颈部疼痛前来我院就诊。通过体格检查、实验室检查和超声检查结果确诊为SAT。治疗后，甲状腺超声复查显示两叶低回声区消退，同时发现一个此前未报告的低回声病变，伴有微钙化灶，边界不规则，与位于叶后部的周围实质分界不清（弹性评分：4，应变指数：7.08）。对该结节进行细针穿刺活检；细胞学评估与甲状腺乳头状癌相符。术后病理评估显示为微小乳头状癌。SAT可能会产生超声改变，掩盖乳头状癌的共存。我们建议SAT患者康复后进行超声检查。治疗后随访超声中出现的大于1 cm的低回声区应通过活检进行评估。
