Journal of Endocrinological Investigation

, Volume 24, Issue 11, pp 892–896 | Cite as

Medullary thyroid cancer, papillary thyroid microcarcinoma and Graves’ disease: An unusual clinical coexistence

  • G. Mazziotti
  • M. Rotondi
  • G. Manganella
  • R. Franco
  • P. F. Rambaldi
  • S. Capone
  • V. Colantuoni
  • G. Amato
  • Carlo Carella
Case Report


We describe the unusual case of a Caucasian woman who had a diagnosis of medullary thyroid cancer and papillary microcarcinoma 5 years after a diagnosis of Graves’ disease. The patient came to our observation for recurrence of hyperthyroidism. An ultrasound scan revealed diffuse thyroid enlargement with a nodule, recently increased in size. The serum CT and carcinoembrional antigen were elevated, and the fine-needle aspiration cytology with immunocytochemical analysis for CT was suggestive for medullary thyroid carcinoma. The nodular lesion showed intense 111In-pentetreotide uptake, whereas total body scintigraphy with the same tracer and with Thallium- 201, 99mTc (V) dimercaptosuccinic acid was negative for lymph node and distant metastasis. The histological examination of thyroidectomy specimens confirmed the diagnosis of medullary thyroid cancer, showing a lymphocytic intratumoral infiltration. The histological analysis of the controlateral lobe showed an occult papillary microcarcinoma. Medullary thyroid carcinoma and papillary microcarcinoma showed intense staining with policlonal anti-RET antibodies, although genetic analysis was negative for RET mutations most frequently involved in familial and sporadic medullary thyroid carcinomas. Possible implications about the coexistence of the 3 thyroid diseases are discussed.


Medullary thyroid carcinoma papillary thyroid carcinoma Graves’ disease 


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Copyright information

© Italian Society of Endocrinology (SIE) 2001

Authors and Affiliations

  • G. Mazziotti
    • 1
  • M. Rotondi
    • 1
  • G. Manganella
    • 1
  • R. Franco
    • 3
  • P. F. Rambaldi
    • 2
  • S. Capone
    • 4
  • V. Colantuoni
    • 4
  • G. Amato
    • 1
  • Carlo Carella
    • 1
  1. 1.Endocrinology InstituteSecond University of NaplesNapoliItaly
  2. 2.Radiology InstituteSecond University of NaplesItaly
  3. 3.Department of Biomorphology“Federico II” UniversityNaplesItaly
  4. 4.Department of Biochemistry and Medical Biotechnologies“Federico II” UniversityNaplesItaly

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