Endocrinol Metab.  2013 Sep;28(3):226-230. 10.3803/EnM.2013.28.3.226.

Graves' Disease that Developed Shortly after Surgery for Thyroid Cancer

• Yu HM
• Park SH
• Lee JM
• Park KS

• KMID: 1973828
• DOI: http://doi.org/10.3803/EnM.2013.28.3.226

Abstract

Graves' disease is an autoimmune disorder that may present with various clinical manifestations of hyperthyroidism. Patients with Graves' disease have a greater number of thyroid nodules and a higher incidence of thyroid cancer compared with patients with normal thyroid activity. However, cases in which patients are diagnosed with recurrence of Graves' disease shortly after partial thyroidectomy for thyroid cancer are very rare. Here we report a case of hyperthyroid Graves' disease that occurred after partial thyroidectomy for papillary thyroid cancer. In this case, the patient developed hyperthyroidism 9 months after right hemithyroidectomy, and antithyroglobulin autoantibody and thyroid stimulating hormone receptor stimulating autoantibody were positive. Therefore, we diagnosed Graves' disease on the basis of the laboratory test results and thyroid ultrasonography findings. The patient was treated with and maintained on antithyroid drugs. The mechanism of the recurrence of Graves' disease in this patient is still unclear. The mechanism may have been the improper response of the immune system after partial thyroidectomy. To precisely determine the mechanisms in Graves' disease after partial thyroidectomy, further studies based on a greater number of cases are needed.

Keyword

Graves' disease; Partial thyroidectomy; Thyroid cancer, papillary

MeSH Terms

Antithyroid Agents
Autoantibodies
Carcinoma
Graves Disease
Humans
Hyperthyroidism
Immune System
Incidence
Receptors, Thyrotropin
Recurrence
Thyroid Gland
Thyroid Neoplasms
Thyroid Nodule
Thyroidectomy
Antithyroid Agents
Autoantibodies
Carcinoma
Receptors, Thyrotropin
Thyroid Neoplasms

Figure

• 

  Fig. 1 Thyroid ultrasound before surgery. (A) Thyroid ultrasound shows an approximately 0.5×0.6-cm sized hypoechoic nodule in the right thyroid. (B) Ultrasound of the left thyroid shows normal findings.

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  Fig. 2 Thyroid ultrasound after right partial thyroidectomy. (A) Thyroid ultrasound shows an enlarged left thyroid gland and hypoechogenicity in the transverse section. (B) In the longitudinal section, the aforementioned findings were also observed.

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  Fig. 3 Histological examination of the surgical specimen. Papillary thyroid cancer cells were seen (A, H&E stain, ×100; B, H&E stain, ×300). A papillary growth pattern is evident.

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