Endocrine Abstracts

Paraneoplastic manifestations of well-differentiated thyroid carcinoma are not so common but they can be the first signal of cancer. We present a case of a man with Raynaud’s phenomenon in the area of the lower limb fingers. Clinical signs of Raynaud’s phenomenon with ulceration and gangrene of fingers of both lower limbs appeared several months before the diagnosis of papillary microcarcinoma of the thyroid was made. The diagnosis of carcinoma of the thyroid was determined based on histological examination. Both serum thyroglobulin and antiperoxidase antibodies were negative. Basic rheumatologic screening was negative. Thyroid cancer was already visible on preoperative ultrasound which showed nodular structure in atrophic thyroid gland. The Raynaud’s phenomenon disappeared after treatment which included total thyroidectomy and application of radiioactive iodine I-131 3700 MBq. Raynaud’s phenomenon was marked as paraneoplastic for obvious connection with thyroid carcinoma. Suspicion of paraneoplastic syndrome can be pronounced on the basis of certain anamnestic and clinical features, however a definitive diagnosis can be determined after recognition of a tumor. Late manifestation of symptoms after the 50th year of life with acute onset, rapid progression and atypical development belongs to the most important traces of paraneoplasia.