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A Case of simultaneous occurrence of Marine - Lenhart syndrome and a papillary thyroid microcarcinoma.
BMC Endocr Disord. 2013 May 08; 13:16.BE

Abstract

BACKGROUND

Marine-Lenhart syndrome is defined as the co-occurrence of Graves' disease and functional nodules. The vast majority of autonomous adenomas are benign, whereas functional thyroid carcinomas are considered to be rare. Here, we describe a case of simultaneous occurrence of Marine-Lenhart syndrome and a papillary microcarcinoma embedded in a functional nodule.

CASE PRESENTATION

A 55 year-old, caucasian man presented with overt hyperthyroidism (thyrotropin (TSH) <0.01 μIU/L; free thyroxine (FT4) 3.03 ng/dL), negative thyroid peroxidase and thyroglobulin autoantibodies, but elevated thyroid stimulating hormone receptor antibodies (TSH-RAb 2.6 IU/L). Ultrasound showed a highly vascularized hypoechoic nodule (1.1 × 0.9 × 2 cm) in the right lobe, which projected onto a hot area detected in the 99mtechnetium thyroid nuclear scan. Overall uptake was increased (4.29%), while the left lobe showed lower tracer uptake with no visible background-activity, supporting the notion that both Graves' disease and a toxic adenoma were present. After normal thyroid function was reinstalled with methimazole, the patient underwent thyroidectomy. Histological work up revealed a unifocal papillary microcarcinoma (9 mm, pT1a, R0), positively tested for the BRAF V600E mutation, embedded into the hyperfunctional nodular goiter.

CONCLUSIONS

Neither the finding of an autonomously functioning thyroid nodule nor the presence of Graves' disease rule out papillary thyroid carcinoma.

Authors+Show Affiliations

Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, 1090, Austria. alois.gessl@meduniwien.ac.at.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23657056

Citation

Scherer, Thomas, et al. "A Case of Simultaneous Occurrence of Marine - Lenhart Syndrome and a Papillary Thyroid Microcarcinoma." BMC Endocrine Disorders, vol. 13, 2013, p. 16.
Scherer T, Wohlschlaeger-Krenn E, Bayerle-Eder M, et al. A Case of simultaneous occurrence of Marine - Lenhart syndrome and a papillary thyroid microcarcinoma. BMC Endocr Disord. 2013;13:16.
Scherer, T., Wohlschlaeger-Krenn, E., Bayerle-Eder, M., Passler, C., Reiner-Concin, A., Krebs, M., & Gessl, A. (2013). A Case of simultaneous occurrence of Marine - Lenhart syndrome and a papillary thyroid microcarcinoma. BMC Endocrine Disorders, 13, 16. https://doi.org/10.1186/1472-6823-13-16
Scherer T, et al. A Case of Simultaneous Occurrence of Marine - Lenhart Syndrome and a Papillary Thyroid Microcarcinoma. BMC Endocr Disord. 2013 May 8;13:16. PubMed PMID: 23657056.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Case of simultaneous occurrence of Marine - Lenhart syndrome and a papillary thyroid microcarcinoma. AU - Scherer,Thomas, AU - Wohlschlaeger-Krenn,Evelyne, AU - Bayerle-Eder,Michaela, AU - Passler,Christian, AU - Reiner-Concin,Angelika, AU - Krebs,Michael, AU - Gessl,Alois, Y1 - 2013/05/08/ PY - 2012/11/09/received PY - 2013/04/23/accepted PY - 2013/5/10/entrez PY - 2013/5/10/pubmed PY - 2013/5/10/medline SP - 16 EP - 16 JF - BMC endocrine disorders JO - BMC Endocr Disord VL - 13 N2 - BACKGROUND: Marine-Lenhart syndrome is defined as the co-occurrence of Graves' disease and functional nodules. The vast majority of autonomous adenomas are benign, whereas functional thyroid carcinomas are considered to be rare. Here, we describe a case of simultaneous occurrence of Marine-Lenhart syndrome and a papillary microcarcinoma embedded in a functional nodule. CASE PRESENTATION: A 55 year-old, caucasian man presented with overt hyperthyroidism (thyrotropin (TSH) <0.01 μIU/L; free thyroxine (FT4) 3.03 ng/dL), negative thyroid peroxidase and thyroglobulin autoantibodies, but elevated thyroid stimulating hormone receptor antibodies (TSH-RAb 2.6 IU/L). Ultrasound showed a highly vascularized hypoechoic nodule (1.1 × 0.9 × 2 cm) in the right lobe, which projected onto a hot area detected in the 99mtechnetium thyroid nuclear scan. Overall uptake was increased (4.29%), while the left lobe showed lower tracer uptake with no visible background-activity, supporting the notion that both Graves' disease and a toxic adenoma were present. After normal thyroid function was reinstalled with methimazole, the patient underwent thyroidectomy. Histological work up revealed a unifocal papillary microcarcinoma (9 mm, pT1a, R0), positively tested for the BRAF V600E mutation, embedded into the hyperfunctional nodular goiter. CONCLUSIONS: Neither the finding of an autonomously functioning thyroid nodule nor the presence of Graves' disease rule out papillary thyroid carcinoma. SN - 1472-6823 UR - https://www.unboundmedicine.com/medline/citation/23657056/A_Case_of_simultaneous_occurrence_of_Marine___Lenhart_syndrome_and_a_papillary_thyroid_microcarcinoma_ L2 - https://bmcendocrdisord.biomedcentral.com/articles/10.1186/1472-6823-13-16 DB - PRIME DP - Unbound Medicine ER -