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Hormones

, Volume 12, Issue 2, pp 298–304 | Cite as

Euthyroid Graves’ orbitopathy and incidental papillary thyroid microcarcinoma

  • Eugen Melcescu
  • William B. Horton
  • Karen T. Pitman
  • Vani Vijayakumar
  • Christian A. Koch
Case report

Abstract

Euthyroid Graves’ orbitopathy (GO) combined with incidental papillary thyroid microcarcinoma has rarely been reported. CASE REPORT: A 61-year-old caucasian woman initially presented with progressive fatigue, exophthalmos, and thyroid function tests within normal limits. She underwent thyroidectomy, was found to have two incidental papillary thyroid microcarcinomas, and received radioactive iodine ablation to eliminate thyroid antigen. In addition to following her eye disease, TSH-receptor antibodies, thyroid stimulating immunoglobulins, and serum thyroglobulin measurements were recorded, demonstrating no evidence of thyroid cancer at four-year follow-up. At first, she had mild GO, developing into moderate-to-severe GO, and at 4 years she had Hertel measurements of 20 mm in both eyes. CONCLUSION: This report underscores the difficulty of managing GO even when thyroid function is normal(ized) and thyroid antigen exposure has been minimized. In addition, it illustrates why antithyroidal antibodies should be considered in cases of concomitant papillary thyroid cancer, as thyroid cells can be stimulated not only by TSH but also by TSH-receptor stimulating antibodies.

Key words

Antibody Graves’ disease Orbitopathy Radioactive iodine Thyroid carcinoma 

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Copyright information

© Hellenic Endocrine Society 2013

Authors and Affiliations

  • Eugen Melcescu
    • 1
  • William B. Horton
    • 1
  • Karen T. Pitman
    • 2
    • 3
  • Vani Vijayakumar
    • 3
    • 4
  • Christian A. Koch
    • 1
    • 3
    • 5
  1. 1.Department of MedicineUniversity of Mississippi Medical CenterJacksonUSA
  2. 2.Department of OtolaryngologyUniversity of Mississippi Medical CenterJacksonUSA
  3. 3.Cancer Institute, Division of Endocrinology, University of Mississippi Medical CenterUniversity of Mississippi Medical CenterJacksonUSA
  4. 4.Department of Radiology / Nuclear MedicineUniversity of Mississippi Medical CenterJacksonUSA
  5. 5.G.V. (Sonny) Montgomery VA Medical CenterMedical ServiceJacksonUSA

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