Endocrinol Metab.  2011 Dec;26(4):324-329. 10.3803/EnM.2011.26.4.324.

A Case of Subacute Thyroiditis Associated with Papillary Thyroid Carcinoma and Takayasu's Arteritis

• Yi D
• Baek SH
• Son SM
• Kang YH

• KMID: 2169263
• DOI: http://doi.org/10.3803/EnM.2011.26.4.324

Abstract

Subacute thyroiditis is a self-limiting inflammation of the thyroid, presenting with painful thyroid swelling, thyrotoxicosis and low radioactive iodine uptake. The characteristic US findings for this disease are focal ill-defined hypoechoic areas in one lobe or diffuse hypoechoic areas in both lobes. Thyroid carcinomas should be included in the differential diagnosis for a lesion with focal hypoechoic areas and have been rarely reported to coexist with subacute thyroiditis. Takayasu's arteritis is an autoimmune disease that affects the aorta and its branches as well as pulmonary arteries. Subacute thyroiditis associated with Takayasu's arteritis is extremely rare, with only three cases being reported. We report here on the first case with the simultaneous diagnosis of subacute thyroiditis, papillary thyroid carcinoma and Takayasu's arteritis.

Keyword

Papillary thyroid carcinoma; Subacute thyroiditis; Takayasu's arteritis

MeSH Terms

Aorta
Autoimmune Diseases
Carcinoma
Diagnosis, Differential
Inflammation
Iodine
Pulmonary Artery
Takayasu Arteritis
Thyroid Gland
Thyroid Neoplasms
Thyroiditis, Subacute
Thyrotoxicosis
Carcinoma
Iodine
Thyroid Neoplasms

Figure

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  Fig. 1 Ultrasonogram. A. Left thyroid sonogram shows a focal ill-defined hypoechoic area. B. Right thyroid sonogram shows a 1.1 × 0.8 × 0.9 cm sized hypoechoic solid nodule with micro/macrocalcifications. C. Transverse sonogram of the left common carotid artery shows concentric wall thickening. D. Longitudinal sonogram of the left common carotid artery shows long segmental wall thickening.

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  Fig. 2 Thyroid scan. 99mTc O4 thyroid scan shows markedly decreased uptake in thyroid area.

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  Fig. 3 3D computed tomography angiography. A. It shows circumferential thickening of the wall of the descending thoracic aorta. B. It shows total occlusion in long segment of proximal portion of the left subclavian artery.

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  Fig. 4 Conventional angiography. A. It shows occlusion of proximal portion of the left subclavian artery at just distal portion of the left thyrocervical artery. B. There are numerous collateral circulations supplying the distal portion of the left subclavian artery.

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  Fig. 5 Pathology of the resected thyroid. A. There is papillary growth pattern represented by finger-like projections lined by neoplastic cells (H&E stain, × 400). B. It shows focal infiltration of inflammatory cells (H&E stain, × 400). C. It shows mild interstitial fibrosis (H&E stain, × 40).

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