ArticleAACE clinical case reports
METASTATIC HÜRTHLE CELL CARCINOMA PRESENTING WITH LOW FREE THYROXINE, SEVERE HYPERCALCEMIA AND SPURIOUS GROWTH HORMONE PRODUCTION.
Article in AACE clinical case reports. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed, 2 citations in OpenAlex.
- Review
- Two synchronous paraneoplastic endocrine syndromes in a 53-year-old male with broadly metastatic widely invasive Hürthle cell carcinoma.Endocrinology, diabetes & metabolism case reports · 2024Article
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveHürthle cell tumors constitute about 5% of thyroid neoplasms. They have malignant potential, behaving very aggressively compared to other differentiated thyroid cancers. The objective of this case report is to describe a case of a Hürthle cell carcinoma with a single large metastasis in the liver presenting almost 17 years after hemithyroidectomy. We highlight the difficulties in making a histologic diagnosis and the unpredictable nature of this cancer.
methodsThe patient history and biochemistry were detailed. Thyroid function tests analyzed on multiple platforms (single-photon emission computed tomography, dynamic magnetic resonance imaging, technetium-99m bone scan, and radioactive iodine) were used to aid biochemical and radiologic diagnosis.
resultsThe patient's thyroid function test showed persistently low free thyroxine concentrations with normal thyroid stimulating hormone and free triiodothyronine, suggesting rapid deiodination in the context of a large liver lesion. Radiologic and morphologic appearances of the liver lesion led to an initial misdiagnosis of primary hepato-cellular carcinoma, revised to metastatic Hürthle cell carcinoma after positive immunochemistry. Nonparathyroid hormone-related intractable hypercalcemia of malignancy with an unusual pattern of elevated 1,25-dihydroxyvitamin D and raised fibroblast growth factor 23 concentrations culminated in his demise.
conclusionsIn Hürthle cell carcinomas treated with partial thyroidectomy, subsequent abnormal thyroid functions tests may herald a more sinister underlying diagnosis. The management of Hürthle cell carcinoma relies heavily on the initial histology results. Histologic diagnosis should be sought earlier in abnormal and suspicious distant masses. Malignant hypercalcemia poses a great challenge in delayed presentations and can prove resistant to conventional treatments.
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