Rees David Owen, Anthony Victoria Angharad, Jones Keston, Stephens Jeffrey W
Department of Diabetes & Endocrinology, ABM University Health Board, Swansea, UK.
College of Medicine, Swansea University, Swansea, UK.
BMJ Case Rep. 2015 May 6;2015:bcr2014207091. doi: 10.1136/bcr-2014-207091.
Thyroid 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.
表现为高功能甲状腺结节的甲状腺癌很罕见。当组织病理学本身的解读并不直接明了时，情况就更加复杂了。我们描述了一例16岁女孩的病例，她有甲状腺毒症的临床和生化证据，以及一个4厘米的甲状腺肿块。超声和甲状腺摄取扫描显示为毒性腺瘤。由于结节大小，对甲状腺腺瘤进行了细针穿刺，结果显示与毒性腺瘤一致。然而，鉴于结节大小，进行了甲状腺半叶切除术。甲状腺组织学检查显示为甲状腺乳头状癌的滤泡变体，患者随后接受了甲状腺全切术。我们报告了该病例，并简要回顾了与这种表现的诊断挑战相关的现有文献。
