title: Papillary thyroid carcinoma without metastases manifesting as an autonomously functioning thyroid nodule.
abstract: A 59-year-old woman with papillary thyroid carcinoma inside of an autonomously functioning thyroid nodule is described in this report. The patient was referred to our clinic because of rapid weight loss and swelling on the left side of the neck. Ultrasonography of the thyroid demonstrated a nonhomogeneous nodule in the lower part of an enlarged left lobe. Both 99mTc and 123I thyroid scintigraphic imaging showed a hot area corresponding to the nodule with lower uptake in the remaining thyroid tissue. Histopathological examination of the nodule revealed papillary adenocarcinoma, and the immunohistochemistry proved weak but positive staining for triiodothyronine and thyroxine. Based on these findings, the nodule was diagnosed as a functioning papillary adenocarcinoma. Although thyroid carcinoma manifesting as a hot nodule on the radionuclide isotope scan is an extremely rare occurrence, the current case is clinically important because it suggests that the diagnosis of a hot nodule cannot always rule out thyroid carcinoma in the nodule, and that even a hot nodule requires careful management so that the malignancy is not overlooked.
authors: Department of Endocrinology and Metabolism, Rakuwakai Otowa Hospital, Kyoto, Japan.
authors: Takafumi
authors: T
authors: Majima
authors: Kentaro
authors: K
authors: Doi
authors: Yasato
authors: Y
authors: Komatsu
authors: Hiroshi
authors: H
authors: Itoh
authors: Atsushi
authors: A
authors: Fukao
authors: Michika
authors: M
authors: Shigemoto
authors: Chieko
authors: C
authors: Takagi
authors: Jerry
authors: J
authors: Corners
authors: Naomi
authors: N
authors: Mizuta
authors: Ryohei
authors: R
authors: Kato
authors: Kazuwa
authors: K
authors: Nakao
mesh_terms: D000231:Adenocarcinoma, Papillary / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D044963:Biopsy, Fine-Needle; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D011877:Radionuclide Imaging; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D016606:Thyroid Nodule / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D013965:Thyroidectomy; D013974:Thyroxine / Q000032:analysis; D014284:Triiodothyronine / Q000032:analysis
chemical_list: D014284:Triiodothyronine; D013974:Thyroxine