title: Large thyroid cyst in a patient with congenital hypothyroidism.
abstract: Thyroid hormone biosynthetic defects are rare causes of congenital hypothyroidism. Although, initial presentations are usually diffuse goiter and hypothyroidism, subsequently they may develop thyroid nodules and or thyroid cancer. We describe a case of hypothyroidism due to dyshormonogenesis whose one of the previously solid nodules degenerates into a large cyst. A 22-year-old male was referred to our clinic for evaluation of enlarging thyroid nodule. Hypothyroidism was diagnosed in infancy, however due to poor compliance to treatment TSH values were elevated most of the times. When he was fifteen the first nodule was detected which was a solid cold nodule. Fine needle aspiration was in favor of benign follicular nodule. Seven years later we found a large multi nodular thyroid with a predominant large cyst corresponding to the previously detected solid nodule. 21cc straw colored fluid was aspirated. Cytology was reported as benign cystic nodule. The patient underwent thyroidectomy and pathology confirmed a benign thyroid cyst. Although underreported thyroid dyshormonogenesis may progress to cystic degeneration. Taking into account the risk of malignancy and eventually cyst formation, we recommend more frequent evaluation in the face of nodule formation in these patients.
authors: Department of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran.
authors: Mahmoud Ali
authors: MA
authors: Kaykhaei
authors: Department of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran.
authors: Zahra
authors: Z
authors: Heidari
authors: Department of Nuclear Medicine, Zahedan University of Medical Sciences, Zahedan, Iran.
authors: Ahmad
authors: A
authors: Mehrazin
mesh_terms: D044963:Biopsy, Fine-Needle; D003409:Congenital Hypothyroidism / Q000097:blood / Q000188:drug therapy / Q000601:surgery*; D003560:Cysts / Q000175:diagnosis / Q000473:pathology*; D018450:Disease Progression; D006044:Goiter, Nodular / Q000175:diagnosis / Q000473:pathology*; D006801:Humans; D008297:Male; D016606:Thyroid Nodule / Q000175:diagnosis / Q000473:pathology*; D013965:Thyroidectomy; D013972:Thyrotropin / Q000187:drug effects; D013974:Thyroxine / Q000627:therapeutic use; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D013972:Thyrotropin; D013974:Thyroxine