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Society for Endocrinology Endocrine Update 2018

Clinical Update

Workshop D: Disorders of the thyroid gland (II)

ea0055wd2 | Workshop D: Disorders of the thyroid gland (II) | SFEEU2018

An unusual route to the diagnosis of medullary thyroid cancer

Gilroy Michael , Redford Christopher , Dunn Julie , Patel Amita , Kyrodimou Efstathia , Baple Emma , Flanagan Daniel , Vaidya Bijay

We describe a 68 year lady who was found to have bilateral adrenal masses (7 cm on the right side and 1.3 cm on the left) during investigations for gastrointestinal symptoms, in early 2016. Biochemistry revealed high urinary normetanephrines of 41.7pmol/24h (ref 0–3) and metanephrines of 40pmol/24h (ref 0–1.8). A PET and MIBG scan revealed uptake in both adrenals and therefore a diagnosis of bilateral phaeochromocytoma was made. The patient had complained of occasion...

ea0055wd3 | Workshop D: Disorders of the thyroid gland (II) | SFEEU2018

A case of medullary thyroid cancer

Bhatt Dhruti , Shakeel Muhammad , Ah-see Kim , Abraham Prakash , Graveling Alex

Case: A 61 year old female, presented to ENT in July ’17 with 6 month history of left sided neck swelling, gradually increasing in size over the last 1 month prior to presentation. She complained of tenderness over the swelling and pain and discomfort around her left shoulder. She denied any problems with her voice, breathing or swallowing. Her past medical history consisted of recurrent UTI’s, renal stones and medullary sponge kidney. She smokes 15 cigarettes per da...

ea0055wd4 | Workshop D: Disorders of the thyroid gland (II) | SFEEU2018

A thyroid lump presenting in pregnancy

Plichta Piotr

A 34 weeks pregnant woman was reviewed in the joint antenatal clinic with over a month history of neck swelling. Her thyroid function tests showed TSH of 1.39 mU/l and a free T4 of 11 pmol/l. An initial ultrasound of the neck revealed a solitary heterogeneous nodule in the right lobe of the thyroid consistent with U3 morphology (indeterminate). She was reviewed by ENT consultant and had a fine needle aspiration (FNAC). Cytology was consistent with features of papill...

ea0055wd5 | Workshop D: Disorders of the thyroid gland (II) | SFEEU2018

Hashimoto’s Thyroiditis and Thyroid cancer

Alam Kazi , Bhake Ragini , Levy Miles

A 40 year old lady presented to GP with few months history of palpitation, anxiety, frequent stools in April’15. Clinical examination revealed moderate sized goitre, more prominent on right side, mobile, non-tender and no lymphadenopathy. Blood tests consistent with T3 toxicosis with FT3 10 (3.5–6.5), FT4 21 (9–25), TSH <0.05 (0.3–5.0) and thyroid peroxidase antibody positive at 562 IU/ml (0–60). Initiated on Carbim...

ea0055wd6 | Workshop D: Disorders of the thyroid gland (II) | SFEEU2018

Advanced medullary thyroid cancer with metastatic disease at diagnostic in young patient negative for RET mutation- to treat or not to treat with tyrosine-kinase inhibitors

Outas Mariana Costache , Giulea Cosmin

We report a 21-year-old man who referred to endocrinologist following biopsy of a left-sided cervical mass. The pathological examination was diagnostic for medullary thyroid carcinoma (MTC). Physical examination was remarkable for a firm 3-cm nodule in right thyroid lobe and another 3 cm. firm nontender mass in left thyroid lobe. The calcitonin was 15,324 pg/ml, and carcinoembryonic antigen was 415 ng/ml. The calcium level was 10.3 mg/dl (<10 mg/dl) with unsuppressed parat...

ea0055wd7 | Workshop D: Disorders of the thyroid gland (II) | SFEEU2018

A challenging case of progressive follicular thyroid cancer

Hussain Shazia , Brennan Carmel , Plowman Nick , Newbold Kate , Drake William

A 60 year old gentleman with a history of renal stones presented 5 years ago with left sided flank pain. A CT of his renal tract showed an unexpected metastatic deposit in the left iliac crest. Cross-sectional whole body imaging, performed to locate the primary, also identified an expansile soft tissue mass in the T8 vertebral body and a predominantly cystic looking left sided thyroid nodule. He proceeded to have an iliac crest biopsy which was consistent with metastatic folli...