World Journal of Endocrine Surgery

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VOLUME 14 , ISSUE 2 ( May-August, 2022 ) > List of Articles

CASE REPORT

Unilateral Graves’ Disease and Papillary Thyroid Carcinoma: Case Report and Review of Literature

Jaspreet Singh, Ankit Manglunia, Swayamsidha Mangaraj, Amitabh Jena

Keywords : Graves disease, Hyperthyroidism, Papillary thyroid carcinoma, Thyroid, Unilateral Graves’ disease

Citation Information : Singh J, Manglunia A, Mangaraj S, Jena A. Unilateral Graves’ Disease and Papillary Thyroid Carcinoma: Case Report and Review of Literature. World J Endoc Surg 2022; 14 (2):51-54.

DOI: 10.5005/jp-journals-10002-1429

License: CC BY-NC 4.0

Published Online: 15-04-2023

Copyright Statement:  Copyright © 2022; The Author(s).


Abstract

Aim: We aim to report a novel association of unilateral Graves’ disease with papillary thyroid carcinoma affecting the same lobe. Background: Graves’ disease is characterized by diffuse enlargement of the thyroid gland. Unilateral Graves’ disease is a rare clinical entity characterized by enlargement and hyperfunctioning of a single affected thyroid lobe. Case description: A 29-year-old female presented with thyrotoxic symptoms for the last 1 year. The patient underwent detailed clinical, hormonal, and imaging studies, which confirmed the presence of unilateral Graves’ disease. During this evaluation, she was also found to harbor papillary thyroid carcinoma in the same affected lobe. The patient underwent total thyroidectomy, followed by radioactive iodine ablation. Histopathological examination of excised tissue confirmed the presence of papillary thyroid carcinoma. Conclusion: A diffuse goiter is one of the classical and well-characterized manifestations of Graves’ disease. Unilateral Graves’ disease is a rare variant of Graves’ disease characterized by unilobar involvement. The exact underlying mechanism of unilateral lobar involvement is unknown. Clinical significance: The association of papillary thyroid cancer and unilateral Graves’ disease is unique and has not been described earlier. Due to its rarity, the diagnosis might be easily missed or misdiagnosed. We have also reviewed and summarized the relevant cases of unilateral Graves’ disease reported earlier in the literature.


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  1. Pande A, Aggarwal A, Wadhwa R. Unilateral Grave's disease: a rare variant. J Clin Diagn Res 2019;13(9):OD06–OD08. DOI: 10.7860/JCDR/2019/42313.13147
  2. Sakata S, Fuwa Y, Goto S, et al. Two cases of Graves’ disease with presentation of unilateral diffuse uptake of radioisotopes. J Endocrinol Invest 1993;16(11):903–907. DOI: 10.1007/BF03348954
  3. Dimai HP, Ramschak-Schwarzer S, Lax S, et al. Hyperthyroidism of Graves’ disease: evidence for only unilateral involvement of the thyroid gland in a 31-year-old female patient. J Endocrinol Invest 1999;22(3):215–219. DOI: 10.1007/BF03343545
  4. Gratz S, Barth P, Arnold R, et al. Graves’ disease with unilateral radioisotope uptake. Nuklearmedizin 2004;43(5):N66–N68. PMID: 15536692.
  5. Bolognesi M, Rossi R. Unilateral Graves’ disease. Thyroid 2006;16(5):493–495. DOI: 10.1089/thy.2006.16.493
  6. Kisakol G, Cakir M, Gungor K, et al. Two cases of Grave's disease presenting with unilateral involvement of the thyroid gland. Turk Jem 2007;11:64–66.
  7. Wagih S. Graves’ disease affecting one thyroid lobe (unilateral Graves’ disease): case report. Egyptian J Nucl Med 2010;2(1):62–65. DOI: 10.21608/egyjnm.2010.5501
  8. Chen LC, Green JB. First reported case of unilateral Graves’ disease in the left lobe of a bilobar thyroid gland. Thyroid 2011;21(6):683–686. DOI: 10.1089/thy.2010.0343
  9. Gönülalan G, Çakır M. Graves’ disease with unilateral involvement: a rare entity. Turkish Journal of Endocrinology and Metabolism 2011;15(4):128–129.
  10. Eklioglu BS, Atabek ME, Akyurek N, et al. Unilateral Grave's disease in an adolescent: case report. ESPE Abstracts 2015;84:P-3-1219.
  11. AY SA, Baskoy K, Urhan M, et al. A rare variant of hyperthyroidism: unilateral Grave's disease. Endocrine Abstracts 2016;41:EP386.
  12. Manthri RG, Ajit N, Vaikakkara S, et al. Unilateral Graves’ disease: the lesser known. Indian J Nucl Med 2019;34(2):96–98. DOI: 10.4103/ijnm.IJNM_11_19
  13. Fiore E, Vitti P. Serum TSH and risk of papillary thyroid cancer in nodular thyroid disease. J Clin Endocrinol Metab 2012;97(4):1134–1145. DOI: 10.1210/jc.2011-2735
  14. Fu H, Cheng L, Jin Y, et al. Thyrotoxicosis with concomitant thyroid cancer. Endocr Relat cancer 2019;26(7):R395–R413. DOI: 10.1530/ERC-19-0129
  15. Preece J, Grodski S, Yeung M, et al. Thyrotoxicosis does not protect against incidental papillary thyroid cancer. Surgery 2014;156(5):1153–1156. DOI: 10.1016/j.surg.2014.04.025
  16. Chen YK, Lin CL, Chang YJ, et al. Cancer risk in patients with Graves’ disease: a nationwide cohort study. Thyroid 2013;23(7):879–884. DOI: 10.1089/thy.2012.0568
  17. Mekraksakit P, Rattanawong P, Karnchanasorn R, et al. Prognosis of differentiated thyroid carcinoma in patients with Graves disease: a systematic review and meta-analysis. Endocr Pract 2019;25(12):1323–1337. DOI: 10.4158/EP-2019-0201
  18. Boutzios G, Vasileiadis I, Zapanti E, et al. Higher incidence of tall cell variant of papillary thyroid carcinoma in Graves’ disease. Thyroid 2014;24(2):347–354. DOI: 10.1089/thy.2013.0133
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