Thyroid Nodule Requiring Thyroidectomy in a Patient with Thyroid Hemiagenesis
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Thyroid hemiagenesis (TH) is a rare congenital disorder in which one lobe of the thyroid gland fails to develop. Since most patients experience no clinical symptoms, TH is typically diagnosed incidentally by taking imaging of neck region. In this paper, we report a case of right lobe TH associated with follicular neoplasm. A 65-year-old woman was referred for surgery for a left thyroid nodule, diagnosed as suspicious for follicular neoplasm on fine needle aspiration biopsy (FNAB). In 2012, the patient underwent screening by neck ultrasonography and was incidentally diagnosed with right TH and a left thyroid nodule. The patient had routine follow up for the thyroid nodule and thyroid function tests, and she was diagnosed for subclinical hypothyroidism which did not require medicated until 2015. The patient took thyroid hormone medication for 2 years (2015–2017), until her thyroid hormone levels normalized. In 2021, follow up FNAB was performed on the left thyroid nodule, and cytologic evaluation revealed that the nodule was suspicious for follicular neoplasm. Preoperative computed tomography scan revealed an absence of the right thyroid gland and TH was incidentally diagnosed. Left thyroid lobectomy was performed on this patient, and during operation, neither of right thyroid gland nor isthmus were found. Post operatively, she was prescribed with levothyroxine medication for thyroid hormone replacement. The pathologic report revealed nodular hyperplasia with Hashimoto thyroiditis. Regular follow up and surveillance of patients with TH is recommended for the early diagnosis of other thyroid diseases.
Abstract
Thyroid hemiagenesis (TH) is a rare congenital disorder in which one lobe of the thyroid gland fails to develop. Since most patients experience no clinical symptoms, TH is typically diagnosed incidentally by taking imaging of neck region. In this paper, we report a case of right lobe TH associated with follicular neoplasm. A 65-year-old woman was referred for surgery for a left thyroid nodule, diagnosed as suspicious for follicular neoplasm on fine needle aspiration biopsy (FNAB). In 2012, the patient underwent screening by neck ultrasonography and was incidentally diagnosed with right TH and a left thyroid nodule. The patient had routine follow up for the thyroid nodule and thyroid function tests, and she was diagnosed for subclinical hypothyroidism which did not require medicated until 2015. The patient took thyroid hormone medication for 2 years (2015–2017), until her thyroid hormone levels normalized. In 2021, follow up FNAB was performed on the left thyroid nodule, and cytologic evaluation revealed that the nodule was suspicious for follicular neoplasm. Preoperative computed tomography scan revealed an absence of the right thyroid gland and TH was incidentally diagnosed. Left thyroid lobectomy was performed on this patient, and during operation, neither of right thyroid gland nor isthmus were found. Post operatively, she was prescribed with levothyroxine medication for thyroid hormone replacement. The pathologic report revealed nodular hyperplasia with Hashimoto thyroiditis. Regular follow up and surveillance of patients with TH is recommended for the early diagnosis of other thyroid diseases.
참고문헌 (16)
- Wu YH, "Thyroid hemiagenesis : a case series and review of the literature", Am J Otolaryngol, 33, pp.299~302 (2012)
- McLean R, "Thyroid dysgenesis in monozygotic twins : variants identified by scintigraphy", Eur J Nucl Med, 10, pp.346~348 (1985)
- Léger J, "Thyroid developmental anomalies in first degree relatives of children with congenital hypothyroidism", J Clin Endocrinol Metab, 87, pp.575~580 (2002)
- Korpal-Szczyrska M, "Prevalence of thyroid hemiagenesis in an asymptomatic schoolchildren population", Thyroid, 18, pp.637~639 (2008)
- Maiorana R, "Thyroid hemiagenesis : prevalence in normal children and effect on thyroid function", J Clin Endocrinol Metab, 88, pp.1534~1536 (2003)
- Shabana W, "Prevalence of thyroid hemiagenesis : ultrasound screening in normal children", Eur J Pediatr, 159, pp.456~458 (2000)
- Bergami G, "Echographic diagnosis of thyroid hemiagenesis", Minerva Endocrinol, 20, pp.195~198 (1995)
- De Sanctis V, "Thyroid hemiagenesis from childhood to adulthood : review of literature and personal experience", Pediatr Endocrinol Rev, 13, pp.612~619 (2016)
- Ruchala M, "Increased risk of thyroid pathology in patients with thyroid hemiagenesis : results of a large cohort case-control study", Eur J Endocrinol, 162, pp.153~160 (2010)
- Szczepanek-Parulska E, "Thyroid hemiagenesis : incidence, clinical significance, and genetic background", J Clin Endocrinol Metab, 102, pp.3124~3137 (2017)
- Szczepanek-Parulska E, "Does TSH trigger the anti-thyroid autoimmune processes? Observation on a large cohort of naive patients with thyroid hemiagenesis", Arch Immunol Ther Exp(Warsz), 64, pp.331~338 (2016)
- Gursoy A, "Clinical and epidemiological characteristics of thyroid hemiagenesis : ultrasound screening in patients with thyroid disease and normal population", Endocrine, 33, pp.338~341 (2008)
- Faulkner J, "A UK reported case of Graves’ disease with thyroid hemiagenesis", BMJ Case Rep, 12, pp.e228094~ (2019)
- Huang SM, "Right thyroid hemiagenesis associated with papillary thyroid cancer and an ectopic prelaryngeal thyroid : a case report", J Formos Med Assoc, 101, pp.368~371 (2002)
- Kartini D, "Thyroid hemiagenesis associated with Hurthle cell carcinoma : a case report", Int J Surg Case Rep, 86, pp.106372~ (2021)
- Pizzini AM, "Thyroid hemiagenesis and incidentally discovered papillary thyroid cancer : case report and review of the literature", J Endocrinol Invest, 28, pp.66~71 (2005)