Papillary thyroid carcinoma after radioactive iodine treatment for toxic thyroid nodule: Case report

Yıl 2018, , 50 - 53, 27.02.2018

Barış Sevinç , Ömer Karahan Cevdet Duran Mustafa Çaycı Serden Ay

https://doi.org/10.5472/marumj.399212

Öz

Radioactive iodine (RAI) treatment is recommended as the first choice for toxic thyroid nodules by American Thyroid Association (ATA). Here, we present our second case of papillary thyroid carcinoma after RAI therapy. A fifty fiveyear-old woman received RAI therapy for toxic thyroid nodule in the right lobe in 2005. Pre-treatment fine needle aspiration biopsy (FNAB) revealed benign cytology. She was euthyroid after the therapy. However, 8 years after the treatment she had 15 mm thyroid nodule in the same location. This time, FNAB result was suspected for papillary thyroid carcinoma. The patient underwent bilateral total thyroidectomy and the histopathological evaluation revealed papillary thyroid carcinoma in the nodule. This is the second case with papillary carcinoma after RAI therapy. Papillary carcinoma developed after the RAI therapy. In conclusion, all cases should be closely followed up after RAI therapy for carcinoma development.

Anahtar Kelimeler

Papillary cancer, Toxic thyroid nodule, Radioactive iodine

Toksik tiroit nodülü için radyoaktif iyot tedavisinden sonra gelişen tiroit papiller karsinomu: Olgu sunumu

Öz

Amerikan Tiroit Derneği (ATA) toksik tiroit nodüllerinde ince iğne aspirasyon biyopsisi (İİAB) yapılmaksızın radyoaktif iyot (RAI) tedavisi önermektedir. Elli beş yaşında kadın hasta 2005 yılında tespit edilen tiroit sağ lobunda yerleşimli toksik nodül nedeniyle RAI tedavisi almış. Hastanın RAI öncesi yapılan İİAB sonucu benign tiroit nodülü olarak rapor edilmiş. Hastanın 8 yıl sonra yapılan kontrol ultrasonografisinde tiroit sağ lobda yerleşimli 15 mm çaplı solid nodül saptandı. Hastaya yapılan İİAB sonucu papiller karsinom açısından şüpheli olarak rapor edildi. Hastaya bilateral total tiroidektomi yapıldı. Histopatolojik incelemede nodülde papiller tiroit karsinomu tespit edildi. Bu vaka RAI sonrası karşılaştığımız ikinci papiller karsinom vakasıdır. Bu yazıda sunduğumuz olgu, RAI öncesi hastanın karsinomunun olmadığı ve kanser gelişiminin RAI tedavisi sonrası olduğu İİAB ile gösterilmiştir. Sonuç olarak, RAI tedavisi alan hastalar uzun dönemde karsinom gelişimi açısından yakın takip edilmelidir.

Anahtar Kelimeler

Papiller Kanser, Toksik tiroid nodülü, Radyoaktif iyot

Kaynakça

• Mazzaferri EL. Management of a solitary thyroid nodule. N Eng J Med 1993;328:553-9. doi: 10.1056/ NEJM199302253280807
• AACE/AME Guidelines. AACE/AME task force on thyroid nodules. American Association of Clinical Endocrinologist and Associaione Medici Endocrinologimedical guidelines for clinical practice for the diagnosis and management of thyroid nodules. Endocr Pract 2006;12:63-102.
• Ziessman HA, O’malley JP, Thrall JH (Eds). Nuclear Medicine. Elsevier Mosby Philadelphia, PA: Elsevier Mosby,2006, 3-19.
• Staffurth JS, Holl-Allen RTJ. Follicular carcinoma of the thyroid following radioactive iodine treatment for Graves’ disease. Postgrad Med J 1988;64:878-80. doi: 10.1136/pgmj.64.757.878
• Maatouk J, Barklow TA, Zakaria W, Al-Abbadi MA. Anaplastic thyroid carcinoma arising in long-standing multinodular goiter following radioactive iodine therapy. Acta Cytol 2009;53:581-3. doi:10.1159/000325388
• Cannizzaro MA, De Maria A, Fazzi C, et al. Anaplastic carcinoma of the thyroid: long-term survival. Minerva Chir 1993;48:1293-9.
• Hayes FJ, Sheahan K, Heffernan A, McKenna TJ. Aggressive thyroid cancer associated with toxic nodular goiter. Eur J Endocrinol 1996;134:366-70. doi: 10.1530/eje.0.1340366
• Vescini F, Di Gaetano P, Vigna E, Pascoli A, Cacciari M. Anaplastic thyroid carcinoma in a 49 year-old woman with a long-standing goiter: A case report. Minerva Endocrinol 2000;25:81-3.
• Duran C, Cayci M, Kutlu O, et al. Papillary thyroid carcinoma developments after radioactive ıodine treatment for toxic adenoma: A Case Report. J Med Cases 2013;4:686-8. doi: 10.4021/jmc1459w
• Rice, CO. Incidence of nodules in the thyroid. Arch Surg 1932; 24:505-15. doi:10.1001/archsurg.1932.01160150168008.
• Mortensen JD, Woolner LB, Bennett WA. Gross and microscopic findings in clinically normal thyroid glands. J Clin Endocrinol Metab 1955;15:1270-80. doi:10.1210/jcem15-10-1270#sthash.4fB9a4TH.dpuf
• Werk EE Jr, Vernon BM, Gonzalez JJ, Ungaro PC, McCoy RC. Cancer in thyroid nodules. A community hospital survey. Arch Intern Med 1984;144:474-76. doi:10.1001/ archinte.1984.00350150058018
• Belfiore A, Giuffrida D, La Rosa GL, et al. High frequency of cancer in cold thyroid nodules occurring at young age. Acta Endocrinol (Copenh) 1989;121:197-202. Hegedüs L. Clinical practice. The thyroid nodule. N Engl J Med 2004;351:1764-71. doi: 10.1056/nejmcp031436
• Lin JD, Chao TC, Huang BY, Chen ST, Chang HY, Hsueh C. Thyroid cancer in the thyroid nodules evaluated by ultrasonography and fine-needle aspiration cytology. Thyroid 2005;15:708-17. doi: 10.1089/thy.2005.15.708
• Singer PA, Cooper DS, Daniels GH, et al. Treatment guidelines for patients with thyroid nodules and welldifferentiated thyroid cancer. American Thyroid Association. Arch Intern Med 1996;156:2165-72. doi:10.1001/ archinte.1996.00440180017002.