E. Lawrence et al., Tall cell papillary thyroid carcinoma metastatic to femur: Evidence for thyroid hormone synthesis within the femur, AM J MED SC, 322(2), 2001, pp. 103-108
Citations number
22
Categorie Soggetti
General & Internal Medicine","Medical Research General Topics
A 67-year old man with a 3-month history of left hip pain had a history of
Graves disease, treated with I-131 20 years before admission, and papillary
thyroid carcinoma, treated with cervical lymphadenopathy 9 years before ad
mission. Removal of a 3.5- x 5-cm mass from the left femur revealed it to b
e a tall cell variant of papillary thyroid carcinoma. Removal of this mass
resulted in his thyrotropin level increasing from 2 (presurgery) to 23 mlU/
mL, whereas his thyroxine level simultaneously decreased from 5.79 (presurg
ery) to 2.29 mug/dL 12 days after surgery despite continuation of levothyro
xine of 0.137 mg/day. On histological examination, the tall cell variant in
the femur was producing abundant thyroglobulin. This first case of a metas
tatic papillary thyroid carcinoma in bone producing thyroid hormone to the
extent that the patient became hypothyroid after removal of this metastasis
illustrates that metastatic thyroid lesion(s) may produce significant amou
nts of thyroid hormone.