Autonomously functioning thyroid nodule treated with radioactive iodine and later diagnosed as papillary thyroid cancer.
Department of 2nd General cancer Surgery, Sisli Etfal Training and Research Hospital, Sisli, Istanbul, Turkey.
The malignancy risk is low in hot thyroid nodules verified by cancer scintigraphy. We present a rare cancer case of papillary carcinoma, initially treated as an autonomous hot nodule. Case cancer report. A 36-year old male cancer patient with a hot thyroid nodule and cancer subclinical hyperthyroidism was treated with 10mCi 131I. On admission, both 99mTc and 131I thyroid scintigraphic imaging revealed a hot nodule at the right lobe cancer accompanied by lower uptake in the remaining cancer thyroid tissue. After treatment, there was a cancer progressive increase in the nodule size; a fine needle aspiration biopsy was thus performed which showed findings cancer compatible with papillary thyroid cancer. The patient was referred to our department for further management. Total cancer thyroidectomy with right central neck dissection was performed. The pathologic examination showed that the whole nodule (1.5 cm diameter) was a columnary type papillary thyroid cancer. Conclusion: In the case of a small-sized toxic thyroid nodule, the possiblility of malignancy cannot be totally ruled out. Suspicious hot nodules should be cytologically evaluated before cancer radioactive iodine treatment to determine the existing malignancy risk. Fine needle aspiration biopsy should be performed in all hot thyroid nodules that increase in size after radioactive iodine treatment.
The malignancy risk is low in hot thyroid nodules verified by cancer scintigraphy. We present a rare cancer case of papillary carcinoma, initially treated as an autonomous hot nodule. Case cancer report. A 36-year old male cancer patient with a hot thyroid nodule and cancer subclinical hyperthyroidism was treated with 10mCi 131I. On admission, both 99mTc and 131I thyroid scintigraphic imaging revealed a hot nodule at the right lobe cancer accompanied by lower uptake in the remaining cancer thyroid tissue. After treatment, there was a cancer progressive increase in the nodule size; a fine needle aspiration biopsy was thus performed which showed findings cancer compatible with papillary thyroid cancer. The patient was referred to our department for further management. Total cancer thyroidectomy with right central neck dissection was performed. The pathologic examination showed that the whole nodule (1.5 cm diameter) was a columnary type papillary thyroid cancer. Conclusion: In the case of a small-sized toxic thyroid nodule, the possiblility of malignancy cannot be totally ruled out. Suspicious hot nodules should be cytologically evaluated before cancer radioactive iodine treatment to determine the existing malignancy risk. Fine needle aspiration biopsy should be performed in all hot thyroid nodules that increase in size after radioactive iodine treatment.
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