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19th European Congress of Endocrinology

Lisbon, Portugal
20 May 2017 - 23 May 2017

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20-23 May 2017, Lisbon, Portugal Further information

Eposter Presentations: Thyroid

Clinical case reports - Thyroid/Others

ea0049ep1192 | Clinical case reports - Thyroid/Others | ECE2017

An adverse outcome in a thyrotoxic lady with propylthiouracil induced necrotising leukocytoclastic vasculitis

Mudenha Emily T , Panthagani Anusha P , Batchelor Jonathan M , Hawari Rand , Stanworth Roger , Hughes David

A 37 year old lady with relapsing Graves’ thyrotoxicosis initially managed on a ‘block and replace regime’ with propylthiouracil and levothyroxine for 7 years had her medication changed to carbimazole after a relapse from non-compliance but developed agranulocytosis. She was then restarted on an increased dose of propylthiouracil alone. Two weeks later, she developed tender purpuric lesions and was admitted after developing painful bullous lesions to her lower l...

ea0049ep1193 | Clinical case reports - Thyroid/Others | ECE2017

Synchronous papillary thyroid carcinoma and primary hyperparathyroidism: a rare association

Khessairi Nadia , Oueslati Ibtissem , Chihaoui Malika , Yazidi Meriem , Rjeb Ons , Chaker Fatma , Slimane Hedia

Introduction: Although the association between parathyroid and thyroid diseases is not uncommon, the coexisting of parathyroid adenoma causing primary hyperparathyroidism (PHPT) and papillary thyroid carcinoma (PTC) is rare. Probably this can be partially explained by different embryologic origin of thyroid and parathyroid cells. Herein, we report a case of PHPT associated with synchronous bifocal PTC.Observation: A 65-year-old woman was referred to our ...

ea0049ep1194 | Clinical case reports - Thyroid/Others | ECE2017

A case with langerhans cell histiocytosis having papillary microcarcinoma of thyroid: two birds in one nest

Ozisik Hatice , Yurekli Banu Sarer , Kutbay Nilufer Ozdemir , Altun Ilker , Ertan Yesim , Makay Ozer , Ozgen Gokhan

Introduction: Langerhans cell histiocytosis (LHH) is an idiopathic, clonal, pleomorphic, neoplastic disorder characterized by the presence of atypical histiocytic cells which are locally or commonly seen in bone, lung, hypothalamus, liver, lymph nodes, mucocutaneous tissues with damaging them.Case: 58 year-old male patient applied to our clinic due to fatigue. On his physical examination, lymphadenopathy and hepatosplenomegaly were absent. In his history...

ea0049ep1195 | Clinical case reports - Thyroid/Others | ECE2017

Amiodarone and refractory thyrotoxicosis in a patient with complex arrhythmia

Cunha Nelson , Gomes Leonor , Martins Diana , Oliveira Diana , Lages Adriana , Ventura Mara , Fadiga Lucia , Catarino Diana , Carrilho Francisco

Background: Amiodarone is a potent antiarrhythmic drug used to treat tachyarrhythmias. However, is linked to a number of adverse effects, including thyroid dysfunction. It is the main cause of drug-induced thyrotoxicosis. Here we report a clinical case of amiodarone-induced thyrotoxicosis (AIT) in a patient with complex ventricular dysrhythmia.Case report: A 23 years-old women with dilated cardiomyopathy, severe depression of ejection fraction of left ve...

ea0049ep1196 | Clinical case reports - Thyroid/Others | ECE2017

Relapsed Graves’ thyrotoxicosis following total thyroidectomy 20 years earlier

Mills Edouard , Naqvi Ali , Todd Jeannie

We report a 55-year-old non-smoker with a history of Graves’ disease diagnosed in 1990 at age 29 years old. Due to poor compliance to therapy, she underwent a total thyroidectomy within 1 year of diagnosis. She remained well controlled on thyroid hormone replacement for over 20 years with Levothyroxine 100 μg daily. However, in the two years before referral to the Endocrine Clinic, she had difficult to treat hypothyroidism with persistent over-replacement; at the tim...

ea0049ep1197 | Clinical case reports - Thyroid/Others | ECE2017

Where is the thyroxin disappearing?

Svilias Ioannis , Gabalec Filip , Cap Jan

Introduction: The most common cause of loss of adequate substitution on a stable dose of replacement therapy is noncompliance. Impaired absorption and weight gain are also possible. We present a rare case of renal loss of thyroxin in severe nephritic syndrome.Case report: We present a 46 year old female after total thyroidectomy for Graves-Basedow disease. From 2005 she was euthyroid on a stable dose of L-thyroxin (100 μg/day). On phy...

ea0049ep1198 | Clinical case reports - Thyroid/Others | ECE2017

Hyalinizing trabecular tumor of the thyroid gland

Bulbul Buket Yilmaz , Celik Mehmet , Ayturk Semra , Can Nuray , Tastekin Ebru , Sezer Atakan , Ustun Funda , Guldiken Sibel

Hyalinizing trabecular tumor is an uncommon, controversial lesion of thyroid gland. Hyalinizing trabecular neoplasm share similarities with medullary thyroid carcinomas (MTC) and exhibit nuclear features resembling papillary thyroid carcinoma (PTC). However, the clinical behaviour unclear. We aimed to present a rare case of hyalinizing trabecular tumor of thyroid gland and ten-year follow up. A 54-year-old woman who was being followed up because of multinodular goiter on exami...

ea0049ep1199 | Clinical case reports - Thyroid/Others | ECE2017

Riedel thyroiditis presenting with pleuro-pericardial involvement

Canpolat Asena Gokcay , Erdogan Murat Faik

Riedel thyroiditis (RT) is a rare kind of chronic thyroiditis which may be a part of a multifocal systemic fibrosis syndrome. When it is generally accepted as a thyroid manifestation of IgG4 related systemic disease. We hereby present a 54 year old woman who was suffering from shortness of breath because of a mass lesion originating from thyroid and invading neck and upper mediastinal structures, leading to dyspnea and dysphagia, as shown by CT, 15 years ago. After an isthmect...

ea0049ep1200 | Clinical case reports - Thyroid/Others | ECE2017

A Novel Thyroid Hormone Receptor Beta Gene Mutation: p.L450F (c.C1633T) in a family with Resistance to Thyroid Hormone

Garcia-Garcia-Doncel Lourdes , Marquez-Pardo Rosa , Torres-Barea Isabel , Baena-Nieto Gloria , Lopez-Velasco Rosario , Cayon-Blanco Manuel

Introduction: Resistance to thyroid hormone (RTH) is a rare autosomal dominant (AD) condition caused by mutations of the Thyroid Hormone Receptor Beta (TR-β) gene, resulting in generalized tissue resistance to thyroid hormone. Euthyroidism is usually maintained at the expense of increased levels of thyroid hormones and with non-supressed TSH.Case report: A 61 year-old-woman was evaluated for increased free T4 index: 2.29 ng/dl (normal, 0.9–2.1)...

ea0049ep1201 | Clinical case reports - Thyroid/Others | ECE2017

Tuberculosis of the thyroid gland: a case report

Sakka Imen , Oueslati Ibtissem , Chaker Fatma , Rjeb Ons , Yazidi Meriem , Chihaoui Malika , Slimane Hedia

Introduction: The involvement of the thyroid gland by tuberculosis is extremely uncommon even in countries in which tuberculosis is endemic. In the majority of the reported cases, thyroid function was preserved. Herein we report a case of thyroid tuberculosis in a patient with a primary hypothyroidism.Case report: A 52-year-old woman was referred to our department for a gradually growing goiter without compressive symptoms. She presented with a productiv...

ea0049ep1202 | Clinical case reports - Thyroid/Others | ECE2017

Follicular variant of papillary thyroid carcinoma with lung, bone, and soft tissue metastases

Belis Constantinos , Gavriilidou Stavroula , Afentoulidi Aikaterini , Xydiari Kalliopi , Athanasiou Vasilios , Malaktari- Skarantavou Sofia , Saranti Sofia , Savvidis Christos

We report on a case of a 63-year-old male patient with a history of metastatic DTC, with both lung and bone metastases and an additional paravertebral mass. The patient presented with enlargement of the left thyroid lobe. FNA was positive for malignancy and subsequent CTs were negative for distant metastases, whereas laboratory tests showed elevated thyroglobulin (Tg>500 ng/ml). The patient underwent total thyroidectomy and the pathology report revealed a multifocal, folli...

ea0049ep1203 | Clinical case reports - Thyroid/Others | ECE2017

Severe acute hepatitis associated with thyrotoxicosis

Torres-Barea Isabel , Garcia-Garcia-Doncel Lourdes , Cayon-Blanco Manuel , Baena-Nieto Gloria , Lopez-Velasco Rosario , Marquez-Pardo Rosa

Liver dysfunction related to hyperthyroidism encompasses abnormalities associated with the effects of thyroid hormone excess, drug-related hepatic injury, and the presence of concomitant liver disease. Mild liver abnormalities such as hypoalbuminemia and increased serum level of liver enzymes may be seen in 45–90% of patients with hyperthyroidism. Nevertheless, there are a few case reports of thyrotoxicosis associated with severe acute hepatitis. A 37 year old woman prese...

ea0049ep1204 | Clinical case reports - Thyroid/Others | ECE2017

Isolated ocular Miasthenia Gravis and Graves’ disease – a challenging ophtalmopathy

de Castro Raquel Vaz , Aragues Jose Maria , Ferreira Florbela , Gomes Vania , Wessling Ana , Fonseca Ana Claudia , Conceicao Isabel , Bugalho Maria Joao

We report the case of a Caucasian woman presenting with a challenging differential diagnosis of ophtalmopathy. The patient was diagnosed with Graves’ disease during postpartum at the age of 28 (TSH<0.001 U/ml; FT3 6.7 ng/dl; FT4 2.2 ng/dl; TSAb 15 U/l). Besides 16 pack-year smoking history, no other previous disease was known. At examination, exophthalmos grade I/III with bilateral lid retraction was evident. Persistency of the disease despite optimal use of medical a...

ea0049ep1205 | Clinical case reports - Thyroid/Others | ECE2017

Pleiotropic function of vitamin D and goiter

Kołodziejczak Roman , Łuczyńska-Kołoldziejczak Alicja , Syrenicz Anhelli

Objective: Among women over 40 the prevalence of goiter in Poland is over 40% and the prevalence of vitamin D deficiency is over 80%. There have not been any previous studies that investigate the vitamin D level in women with and without goiter.Methods: 152 women-96 with and 56 without nontoxic goiter were examined in 2014. In US examination we calculated the volume of the thyroid gland and volume of nodules. Blood samples for 25-(OH) D total were taken....

ea0049ep1206 | Clinical case reports - Thyroid/Others | ECE2017

Amyloid goiter secondary to Crohn’s disease

Saavedra Ana , Rodrigues Elisabete , Marques Ana , Carvalho Davide

Introduction: Amyloidosis results from deposition of insoluble proteins in the extracellular space. It can be both primary or secondary to chronic inflammatory diseases. Although microscopic thyroid involvement is common, cases in which it becomes clinically evident (amyloid goiter) are rare.Case report: Woman, 45 years. In 2009, she was diagnosed with Crohn’s disease after Bartholin’s gland abscess excision and evaluation for weight loss, anem...

ea0049ep1207 | Clinical case reports - Thyroid/Others | ECE2017

Two case reports of amiodarone induced thyroid dysfunction: thyrotoxic and myxedematous crisis

Santos Francisco Sousa , Ferrinho Catia , Capitao Ricardo , Roque Catarina , Bello Carlos , Limbert Clotilde , Vasconcelos Carlos

Introduction: Amiodarone is a well-established antiarrhythmic drug frequently used in tachyarrhythmias. Side effects include hypothyroidism and hyperthyroidism. Extreme cases such as myxedematous and thyrotoxic crisis are very uncommon. Here we report one case of each of these presentations.Case Report no.1: A 73-year-old woman with history of atrial fibrillation under treatment with amiodarone presented to the emergency department with headache, nausea ...

ea0049ep1208 | Clinical case reports - Thyroid/Others | ECE2017

Hashimoto’s thyroiditis in a patient with ectopic thyroid tissue

Khessairi Nadia , Oueslati Ibtissem , Rjeb Ons , Chaker Fatma , Yazidi Meriem , Chihaoui Malika , Slimane Hedia

Introduction: Abnormalities in the development and migration of the thyroid gland are known to produce ectopic thyroid tissue, usually in the midline between the tongue base and the diaphragm. Hashimoto’s thyroiditis involving ectopic thyroid tissue is particularly unusual. Herein we report a case of Hashimoto’s thyroiditis developing in a midline thyroid cervical mass.Observation: A 55-year-old man was referred for hypothyroidism. His physical...

ea0049ep1209 | Clinical case reports - Thyroid/Others | ECE2017

Autoimmune thyroid disease occurring as a possible late complication after a non-occupational HIV Postexposure Prophylaxis

Crumpei Iulia , Mogos Voichita , Ungureanu Maria-Christina , Bursuc Anamaria , Armasu Ioana , Tirnoveanu Mirela , Adomnicai Valentina , Constantinescu Georgiana , Vulpoi Carmen

Introduction: Nonoccupational postexposure prophylaxis (nPEP) is a three-drug antiretroviral regimen used to decrease the risk for HIV infection after less than 72 h from nonoccupational exposure to body fluids that might contain HIV. The most frequent side effects concern the gastro-intestinal intolerance, renal and hepatic toxicity, with no hormonal imbalance to have been yet reported.Case report: 24 years old male patient, consulted for palpitations, ...

ea0049ep1210 | Clinical case reports - Thyroid/Others | ECE2017

Recurrent Thyroiditis in an Amiodarone treated patient: An Illustrative Case Demonstrating the Spectrum of Abnormalities

Kumar Mohit , Tymms David James

A 65 yo gentleman was referred to the endocrinology department with thyrotoxicosis. He had a history of IHD and recurrent VT necessitating amiodarone for 8 years. Routine TFTs had shown TSH undetectable, fT4 34.1, fT3 8.7. There were no symptoms or signs of thyrotoxicosis or cardiovascular compromise. He had been treated with carbimazole by his GP for the previous 3 weeks, this was discontinued at the initial evaluation due to recurrent vomiting. TPO anti...

ea0049ep1211 | Clinical case reports - Thyroid/Others | ECE2017

Thyroid storm subsequent to amiodarone-induced thyrotoxicosis

Machado Catarina , Tavares Patricia , Monteiro Sara , Rocha Gustavo , Oliveira Maria Joao

Introduction: Thyroid storm is a rare medical emergency with high mortality, which usually results from acute exacerbation of hyperthyroidism. Amiodarone is a highly used class III antiarrhythmic drug and amiodarone-induced thyrotoxicosis is an infrequent effect of this medication, whose treatment may be difficult.Case study: A 20-year old male with congenital cardiomyopathy (Fallot tetralogy and Ebstein anomaly), chronically medicated with amiodarone 20...

ea0049ep1212 | Clinical case reports - Thyroid/Others | ECE2017

Atrial flutter with 1:1 atrioventricular conduction: An uncommon cardiac manifestation of hyperthyroidism

Rached Amal , Yazidi Mariem , Sakka Imen , Rejeb Ons , Khessairi Nedia , Chihaoui Malika , Slimane Hedia

Introduction: Atrial flutter (AFL) is a rapid, regular atrial tachyarrhythmia that occurs most commonly in patients with underlying structural heart disease. Patients with tachyarrythmias as a result of thyroid storm have been typically treated with beta-blockers to decrease the heart rate and alleviate beta-receptor mediated symptoms. We report an unusual case of AFL with 1:1 atrioventricular (AV) conduction.Case report: Patient H, M 45 years old was ad...

ea0049ep1213 | Clinical case reports - Thyroid/Others | ECE2017

Pharyngeal Irritation, Incidental Neck Masses; A difficult journey

Grant Bonnie , Tanday Raj , William Augustine , Pittathankal Antony , Casey Edel , Nikookam Khash

This is a case of a 48-year-old lady initially referred to respiratory clinic with symptoms of breathlessness. She had a high-resolution CT thorax where an incidental finding of a right para-oesophageal 2.4-cm soft tissue density at the level of the thyroid gland identified. A CT neck was performed for further evaluation again showed the soft tissue mass (26 mm×37 mm) situated to the right of the oesophagus and another mass (16 mm×26 mm) left of the oesophagus. Discu...

ea0049ep1214 | Clinical case reports - Thyroid/Others | ECE2017

Papillary thyroid microcarcinoma in struma ovarii tissue: a case report

Kirac Cem Onur , Baldane Suleyman , Ipekci Suleyman , Kebapcilar Levent

Introduction: Struma ovarii is an uncommon ovarian neoplasm that more than half of itself is made up of thyroid tissue. In clinical trials about the disease, malign transformation has been detected at the rate of 0.5–5%. Because of the disease’s rareness, there is no absolute agreement about diagnosis and treatment of the disease.Case report: A 33-year-old woman admitted to gynecology department with abdominal pain. Her pelvic MR revealed 147&#...

ea0049ep1215 | Clinical case reports - Thyroid/Others | ECE2017

Simultaneous occurrence of RET-negative Medullary Thyroid Carcinoma (MTC) and extrathyroidal B large cell Non-Hodgkin Lymphoma (NHL)

Lio Serafino

The simultaneous occurrence of MTC and extrathyroidal B large cell NHL are very rare. MTC may be sporadic or part of a MEN and NHL is not reported in association with MEN. A woman of 76 year old with a history of cholelithiasis and hepatitis B, is admitted for left abdominal pain. On examination it is detected inguinal, axillary and clavicular lymphadenopathy, splenomegaly and also a multinodular thyroid disease. The thyroid function was normal, antithyroid antibodies were neg...

ea0049ep1216 | Clinical case reports - Thyroid/Others | ECE2017

miRNAs microarray differential profile in papillary thyroid carcinoma

Schipor Sorina , Niculescu Ana-Maria , Botezatu Anca , Ioachim Dumitru , Manda Dana , Caragheorgheopol Andra , Picu Catalina , Popa Oana , Nedelcu Ioana , Badiu Corin

Introduction: The deregulation in miRNA expression has been described in thyroid tumors, and is considered an important factor in thyroid carcinogenesis. mRNA expression profiling in cancer allows identifications of signatures associated with diagnosis, staging, prognosis, and response to treatment.Objective: We aimed to detect miRNAs species differentially expressed between tumor and peritumoral tissue in papillary thyroid carcinoma.<p class="abstex...

ea0049ep1217 | Clinical case reports - Thyroid/Others | ECE2017

Simultaneous papillary and medullary thyroid carcinoma in siblings with RET 611 mutation. More than a coincidence?

Paja Miguel , Zabalegui Alba , Dublang Maddalen , Etxeberria Eider , Iglesias Natalia C , Calles Laura A , Arrizabalaga Cristina , Lizarraga Aitzol , Gutierrez M Teresa , Ugalde Aitziber

Germinal mutations of the oncogene RET originate the development of medullary thyroid carcinoma (MTC) in carriers with phenotypic expression depending on the mutated codon and other unknown factors. Simultaneous detection of differentiated thyroid carcinomas is considered a casual phenomenon (collision tumours). We communicate two brothers with double heterozygous mutation of maternal inheritance at codon 611 of RET, TGC to TTT, changing to encode phenylalanine (C611F), with a...

ea0049ep1218 | Clinical case reports - Thyroid/Others | ECE2017

Thyroid nodule size at ultrasound as a predictor of malignancy

Gallardo Gema Lopez , Sastre Julia , Gonzalez Abel , Arranz Sandra , Silva Julia , Valero Miguel Angel , Aranda Jaime

Introduction: Most thyroid nodules are benign. Some studies have shown largest nodule size, specially >4 cm, can predict malignancy and reduce fine needle aspiration (FNA) accuracy. Recent studies, however, have shown conflicting results as to whether nodule size may be used to distinguish at risk-lesions. We attempt to determine whether nodule size predicts thyroid malignancy and to examine accuracy of fine needle aspiration (FNA) by size.Material a...

ea0049ep1219 | Clinical case reports - Thyroid/Others | ECE2017

Struma ovarii – A report of thirteen cases

Donato Sara , Simoes Helder , Leite Valeriano

Introduction: Struma ovarii (SO) is a rare ovarian teratoma characterized by the presence of thyroid tissue in >50% of the tumour. Malignant transformation is rare and defined by the same histological criteria as for thyroid cancer. There is few data on the literature and treatment is controversial. The objective of this study was to describe the clinical, pathologic and treatment characteristics of women diagnosed with SO in our centre.Methods: Retr...

ea0049ep1220 | Clinical case reports - Thyroid/Others | ECE2017

Diagnosis of medullary thyroid carcinoma at early stage

Stancu Cristina , Corneci Cristina , Caragheorgheopol Andra , Stanescu Bogdan , Diana Ilie Mirela , Badiu Corin

Medullary thyroid carcinoma (MTC) is a rare neuroendocrine tumor derived from the thyroid C cells producing calcitonin, ac-counts for 0.6% of all thyroid cancers. It occurs either sporadically or in a hereditary form (RET mutation). MTC can be cured only by complete resection of the thyroid tumor and any loco-regional metastases. Calcitonin (CT) measurement is crucial to the early diagnosis and the follow-up of MTC. If the evaluation of stimulated CT levels is required, a prov...

ea0049ep1221 | Clinical case reports - Thyroid/Others | ECE2017

Clinicopathological characteristics and outcomes of differentiated thyroid carcinoma in children and adolescents

Goldstein Andrei Liviu , Chiriac Iulia Andreea , Ghemigian Adina Mariana , Procopiuc Camelia , Ghemigian Mircea Vasile , Brasoveanu Daniel , Goldstein Daniela , Purice Mariana , Alexiu Florin , Voicu Gabriela , Ioachim Dumitru , Gherlan Iuliana

Introduction: Differentiated thyroid carcinoma is a rare entity in pediatric population, with particularities in diagnosis, management and outcomes.Methods, aim: Retrospective noninterventional study describing clinical presentation and outcomes of children with DTC.Results: Between 2011 and 2017 54 children and adolescents aged 7.8–18 years (mean age at diagnoses 14.4 years) with DTC were diagnosed/followed up in our Institut...