Endocrine Abstracts

JOINT1113

Introduction: Follicular epithelial dysplasia (FED) is suggested to be a pathogenic link between inflammation – related atypia and papillary thyroid carcinoma (PTC) and thus a premalignant percursor of papillary thyroid carcinoma, in Hashimoto – thyroiditis (HT) and in chronic lymphocytic thyroiditis (CLT).

Material and methods: A 66-year-old-woman presented with feeling suffocation, frequent heartbeats, sweating, insomnia, hand tremors. Anamnesis revelead that she was diagnosed with Hyperfunctioning Multinodular Goiter 15 years prior and is on antithyroid medication and antihypertensive medication with moderate success in achieving euthyroidism. On admission, the patient had FT4:0.29 ng/dl (ref 0.34 – 5.6 ), FT3: 4.44 pg/ml (ref 2.5 – 4.2 ) TSH:2.65 uUI/ml (0.25 – 5 ). Cervical ultrasound showed an enlarged thyroid with large nodules. Antithyroid medication was adjusted with Favistan 10 mg/day. At the next visit after 6 weeks the lab results: TSH: 0.344 uUI/ml, FT4: 11.3pg/ml, FT3: 5.82 pg/ml, Anti Tg 26, Anti TPO 6.49, TSH receptors 0.8. Total thyroidectomy was recommended to the patient. The post-surgery biopsy confirmed follicular adenoma with foci of epithelial dysplasia.

Conclusion: Our case demonstrate the presence of atypical microscopic lesions even in follicular adenoma

Keywords: follicular adenoma, follicular epithelial dysplasia, hyperfunxioning multinodular goiter.