Endocrine Abstracts

IntroductionVasculitis with antineutrophilic cytoplasmic antibodies (ANCA) has been reported in patients treated with anti-thyroid drugs, especially Propylthiouracil and exceptionally with benzylthiouracil (BTU). We present here a case of ANCA-anti-MPO-associated vasculitis related to BTU.Case presentationA 46 old women was treated with BTU during 18 months for Basedow’s...

IntroductionEctopic thyroid tissue is a rare clinical entity, with a prevalence of 1: 300 000 in the general population. The ectopic tissue may be located anywhere from the base of the tongue to the diaphragm, the most frequent sites being lingual, thyroglossal, laryngotracheal, and lateral cervical regions. It may also occur in less frequent sites such as the esophagus, mediastinum, heart, adrenal glands, and pancreas. The mediastinum is the most freque...

IntroductionThe association between parathyroid and thyroid diseases is not uncommon; however concurrent presence of parathyroid adenoma and thyroid cancer is rare (1). As a natural consequence, preoperative imaging studies for diagnosis and localization of parathyroid adenomas may result with the detection of thyroid incidentalomas and most of these thyroid nodules should be evaluated by fine-needle aspiration biopsy before parathyroid surgery (1). We h...

IntroductionGraves’ disease is an autoimmune thyroid disease manifested by hyperthyroidism, homogeneous goiter and sometimes ophthalmopathy. The frequency of the disease is less than 1% with a female predominance of 5–10/1 male. Its treatment is difficult because of the evolving vagaries of this disease. We report the results of surgery for Graves’ disease through a retrospective study.Material and methods<p clas...

IntroductionDeQuervain’s subacute thyroiditis (DST) is a rare pathology, defined by the involvement of the thyroid gland by an inflammatory process probably of viral origin, not suppurative and not autoimmune. In this context, we report 4 cases of TSD followed up in the endocrinology department over a period of 23 years, to highlight diagnostic and therapeutic particularities.ResultsThe average age was 3...

IntroductionToday, it is well recognized that disturbances in thyroid function may significantly affect mental status including emotion and cognition. Several studies have demonstrated the existence of a relationship between depression and hypothyroidism, although there is still no clear explanation of the pathophysiology that causes this association.ObjectivesTo assess whether there is a higher prevalence of...

Thyroid orbitopathy (TO) is an autoimmune inflammatory disease of retroocular tissues. Mostly, TO is associated with Graves’ hyperthyroidism. The development of TO is accompanied by pathological changes in the soft tissues of the orbit with damage to the optic nerve and cornea, the accessory apparatus of the eye. Despite the presence of specific symptoms, the diagnosis of TO causes problems for doctors. A 61-year-old man complained of discomfort in the eyes, double vision...

IntroductionGraves’ disease (GD) is an autoimmune thyroiditis frequently associated with development of Graves’ orbitopathy (GO). Diplopia (double vision) is a major determinant of work disability in patients with GO. The aim of our study was to assess the prevalence of diplopia and strabismus in patients with GO.MethodsThis is a single-center observational study in an outpatient clinic of autoimmun...

BackgroundThyroidectomy is the common most common endocrine surgical procedure varies from Scalpel to Robotic transoral thyroidectomy. Colloid nodules are common and easily operable without any difficulty. We report a phenomenon where in the surgery becomes difficult and lead to complications if not thought with this phenomenon – colloid leak.Material and methodThe endocrine surgeon (Associate Professor)...

IntroductionThyrotoxicosis debuted early after thyroid lobectomy is described in approximately 54% of cases. It has also been described in a few case reports after non thyroid neck surgeries or in invasive laryngeal cancer after total laryngectomy and debulking hemithyroidectomy.Case presentationPatient aged 53 years old, known with laryngeal carcinoma of 37/28/40 mm located at piriform sinus, linked by the l...

IntroductionThyroid autoantibodies can detected in many disorders not only at the Hosimoto autoimmune thyroiditis. Their level and frequency may vary depending on many factors both thyroidal and nonthyroidal. Anti thyroid peroxidase autoantibodies (ATPO) is one of the well known among them. We analysed frequencies of higher level of ATPO among people with different types of thyroid diseases.Material and methods<p class="abstext...

IntroductionThe synthetic anti-oestrogen tamoxifen is the endocrine treatment modality most commonly used for therapy of hormone sensitive breastcancer. The influence of tamoxifen on thyroid function has not been fully elucidated.ObservationA 46-year-old female patient who presented a Graves’ disease diagnosed 10 years ago. She had a moderate vascular goiter and no ocular signs. She presented firstly a s...

IntoductionThe link between hyperthyroidism and breast cancer has been the subject of much controversy and literature in the past. It poses a daily clinical problem of information and senological follow-up of thyroid patients. We report our patient’s case.ObservationA 46-year-old female patient who presented a Graves’ disease diagnosed 10 years ago. She had a moderate vascular goiter and no ocular s...

BackgroundThe latest WHO classification of tumours of endocrine organs defines new units of borderline thyroid tumours (BTT) of uncertain biological behaviour. The aim of our study was to evaluate ultrasonographic, cytological features, mutation profile and surgery treatment in patients with these rare tumours.MethodsThe analysis of 8 out of 487 operated patients, who underwent thyroid surgery between June 20...

Selpercatinib is a receptor tyrosine kinase RET inhibitor for the treatment of cancers such as RET-mutant medullary thyroid cancer, demonstrating partial response and low incidence of serious adverse events. Vandetanib, a tyrosine kinase inhibitor, has shown promising results with an increase in progression-free survival and prolonged lifetime, but it causes adverse events such as hypertension, diarrhea, rash, or long QT interval. Most of them are can be even disabling for the...

IntroductionPapillary thyroid cancer (PTC) has generally good prognosis irrespective of lymph node metastases. The rate of survival in patients with distant metastases is variable, depending upon the site of metastases and radioiodine accumulation status. The median survival of patients with brain metastases is approximately one year.CaseWe present a 66 years old woman with a tumour triplicity (PTC, breast ca...

ObjectiveThe study’s purpose is to describe the therapeutic management of papillary thyroid microcarcinoma.Material and methodsThis is a retrospective study including 55 cases of papillary thyroid microcarcinoma treated at our department, from 2000 to 2020.ResultsOur study included 8 men and 47 women. The mean age was 48.64 years with extreme ages from 24 to ...

IntroductionProblems with thyroid cancer and its diagnosis are one of the current issues in modern endocrinology. Ultrasound examination detects thyroid nodules in 19-67%of the population, whereas the new classification of thyroid ultrasound examination proposed by the American Association of Thyroidologists – the use of TI-RADS in the diagnosis of thyroid cancer increases the diagnostic accuracy of this test by 91–95%. The aim of our study was...

IntroductionDifferentiated thyroid cancer (DTC) is a rare disease (1%), and usually has good prognosis if well treated. However, the percentage of mortality due to this cancer is about 0.5%. Moreover, 5 to 27%of patients treated for DTC suffer from regional recurrence. Therefore, many research tried to identify predective factors for the survival, relapse and progression of this cancer.PurposeThe aim of our s...

Introduction and objectivesThyroid cancer treatment tends to be individualized based on risk stratification and increasingly less aggressive for low-risk tumors, as recent studies have shown that low doses of I-131 are just as effective than higher doses with excellent remission rates. The objective of our study was to evaluate the response after 1 year of treatment with 30 mCi of I-131 in patients with differentiated thyroid cancer.<p class="abstext...

IntroductionThyroid papillary carcinoma is the most common type of thyroid cancer. Thyroid papillary microcarcinoma is a subtype of papillary carcinoma that includes tumors with 10 mm or less diameter. As a result of diagnostic methods improvement, prevalence of this tumor is increasing. In this study, we reviewed lymph node metastasis characteristics among patients with papillary microcarcinoma.MethodsA retr...

IntroductionFollicular thyroid carcinoma (FTC) has metastasis in 10-15%; papillary thyroid carcinoma (PTC) rarely metastasizes. Bone metastasis are rare and can cause pain, fractures and spinal cord compression.Case-172 year-old male referred to the hospital with lower back pain. Imaging examination revealed lytic lumbar lesions. Thoracic-abdominal-pelvic-CT showed trachea compression by a multinodular right ...

Epithelioid hemangioendotheliomas (EHE) are rare vascular tumors that are typically low to intermediate grade, but they can also have an aggressive behaviour. Mortality rate is dependent on the tumor location. It is frequently a solitary lesion located in the superficial or deep soft tissues, but they can be found in liver, lungs (normally multifocal), pleura, bones, lymph nodes and rarely in the thyroid gland. We describe a case of metastatic EHE with involvement of the thyro...

IntroductionCardiothyreosis is associated with higher morbidity and mortality than other forms of hyperthyroidism. The aim of our study was to identify its therapeutic and evolutive aspects in an adult population of southern Tunisia.MethodsRetrospective study including all cases of cardiothyreosis followed in our department during a period of 20 years.Results100 c...

IntroductionAccessory thyroid is defined as the presence of thyroid tissue in locations other than the normal anterior neck region between the second and fourth tracheal cartilages. It is a congenital disease caused by the abnormal migration of thyroid tissue in the embryonic stage. Lingual thyroid is the most common form of ectopic thyroid, extra lingual thyroid tissue is commonly located in the anterior cervical area, along the path of the thyroglossal...

IntroductionThyroid cancers account for about 2.9%of all cancers. Although it is reported that the risk of developing PTC as the second primary cancer increases after treatment of Hodgkin lymphoma (HL), concomitant PTC and HL are quite rare and to the best of our knowledge we found only three cases in the literature. This case report presents the treatment management and three-year course of a male patient with simultaneous diagnosis of PTC and HL.<p...

RelevanceExcess thyroid hormone as a result of thyroid hyperstimulation affects all types of metabolism, including carbohydrate metabolismPurposeTo assess the incidence of carbohydrate metabolism disorders in children and adolescents with hyperthyroidism.Materials and methodsHormonal analysis of thyroid status (TSH, free and total T3, free and total T4, TSHRAb, TP...

IntroductionThyroid hemiagenesis is defined as the absence of one lobe of the thyroid gland. It represents a rare congenital abnormality with a prevalence of 0.05 to 0.2%. The left lobe is more commonly affected than the right lobe. Thyroid hemiagenesis is incidentally found during a routine thyroid screen. Herein, we report a thyroid hemiagenesis revealed by a compensatory hypertrophy of the contralateral thyroid lobe in an adolescent girl with euthyroi...

IntroductionGraves’ disease is typically characterized by the presence of circulating autoantibodies that stimulate the TSH receptor, inducing hyperthyroidism and goiter. Hashimoto’s thyroiditis is an autoimmune disease leading to thyroid tissue destruction by cell and antibody-mediated immune processes. The development of Hashimoto’s thyroiditis following Graves’ disease is rarely reported. Its pathogenesis is not confirmed. Herein, ...

IntroductionProspective and retrospective trials report the incidence of endocrine adverse events provoked by immune checkpoint inhibitors (ICI) up to 30%. PD-1/PDL inhibitors have a higher incidence of thyroid dysfunction: hypothyroidism 5%-14%, transient hyperthyroidism – 3%-5%.The aim of the study was to assess thyroid function in PD-1/PDL treated patients.Materials and methods6...

The conversion of Hashimoto thyroiditis (HT) to hypothyroidism is frequently observed in daily clinical practice, but the development of Grave’s disease (GD) after long-standing hypothyroidism is rare and intriguing. A 70-year-old woman visited an endocrinologist, complaining of increased heart rate, anxiety, and a feeling of discomfort in the neck. Past medical history revealed HT with hypothyroidism. Laboratory tests showed significantly increased thyroid-stimulating ho...

The long-term androgen deficiency (AD) in men with hypothyroidism is an important problem due to the fact that it leads to concomitant cardiac pathology, which remains the leading cause of mortality in the world. The presence of different points of view on the problem of AD and its effect on the risk factors for cardiovascular disease in patients with hypothyroidismattracts attention. The aim of the study is to assess the clinical signs of age-related androgen deficiency and t...

IntroductionThyrotoxic periodic paralysis (TPP) is a rare complication of hyperthyroidism characterized by the sudden onset of hypokalemia and muscle paralysis. This rare but possible clinical presentation of thyrotoxicosis is significantly more predominant in males of asian descent. The mechanisms of hypokalemia are incompletely understood. The prevailing theories include increased Na-K ATPase pump activity and mutations in genes encoding Kir channels i...

IntroductionImmunological side effects related with use of immune checkpoint inhibitors (ICIs) are named as immune-related adverse events (irAEs). irAEs include clinical pictures such as autoimmune thyroiditis, hypophysitis, primary adrenal insufficiency and autoimmune diabetes mellitus. Nivolumab is an anti-PD-1 (anti-programmed cell death-1) monoclonal antibody approved for the treatment of malignant melanoma, advanced non-small cell lung cancer and ad...

Thyrotoxicosis (T) develops as a result of persistent excess of thyroid hormones (TH). There are two groups of diseases that are fundamentally different in pathogenesis. The first group includes those in which the production of TH increases. Diseases of the second group are accompanied by T caused by destruction of the thyroid gland tissue. Therapeutic approaches for different types of T are different, therefore, a careful differential diagnosis of T is necessary, even if at f...

ObjectivePresentation of multinodular goiter as an unusual feature in a patient with Williams-Beuren Syndrome.MethodsReview of the patient’s clinical records and of the relevant literature.IntroductionThe Williams-Beuren Syndrome is a multisystem disorder caused by a microdeletion of 1.5–1.8 megabase pairs on chromosome 7q11-123, with loss of 26–28 ...

IntroductionGraves’ disease is an autoimmune disorder that has multiple cardiac repercussions including arrhythmias and heart failure. Acute myocarditis is a rarely described complication. In this context, we report a case illustrating this association.Case presentationA 23-year-old man has been followed for Graves’ disease that had been suspected by weight loss, tachycardia and bilateral and asymet...

IntroductionGrave’s disease is an autoimmune disease characterized by hyperthyroidism. It is in some cases associated to more autoimmune organs dysfunction. The antithyroid drugs are the first line treatement, and sometimes they are responsible for severe adverse effects.ObservationWe report the case of a 34 year-old man, treated for his grave’s disease with thiamazol for two years. Two weeks after ...

ObjectivesThere is a paucity of real-world studies on the clinical burden and practice patterns associated with chronic hypoparathyroidism (cHP). This study assesses the comorbidities, treatment and lab testing patterns in cHP patients identified using surgery-based criteria.MethodsThis was a retrospective study conducted using a large (130 million individuals) US claims database (HealthVerity Closed Payer Cl...

High-intensity focused ultrasound ablation (HIFU) was used in the treatment of thyroid nodules using the device “Echopulse” (Theraclion, France). The therapeutic sensor is represented by a piezoelectric lens with a diameter of 12 cm, with a variable radiation frequency from 0.8 to 1.6 MHz. The treatment was carried out automatically after preliminary planning. The impact zone (ablation focus) was marked automatically on the device screen. The limitations for using HI...

A 65-year-old patient was hospitalized three times over a two-year period for severe acute pancreatitis. After the first hospitalization, cholecystectomy was performed. During the second hospitalization she was treated in the ICU because of the development of necrotizing emphysematous pancreatitis with the development of sepsis. During the third hospitalization the patient presents clinically with general weakness, agitation, visual hallucinations, disorientation and damaged c...

BackgroundThe thyroid nodule is a common presentation. Its prevalence is estimated to be 5%. Surgical treatment could not be systematic. It requires structured diagnostic approach to ascertain the risk of malignancy and determine appropriate management.AimTo evaluate potential role of epidemiological, clinical and para clinical criteria as preoperative indcators of malignancy in thyroid nodules.<p class="...

IntroductionThyroid carcinoma is the most common type of endocrine malignancy and the cancer with the largest annual increase in incidence in recent decades. They are classified as primary or metastatic. The most common thyroid cancer subtypes include papillary, follicular, medullary, and anaplastic. We aim to present 11 cases of exceptional thyroid malignancies managed in our department.Materiel and methodsA...