ArticleJCEM case reports2026
Development of Graves orbitopathy after thyroidectomy for thyroid cancer.
Article in JCEM case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
We present a case of a 76-year-old female with a history of papillary thyroid cancer treated with a total thyroidectomy, central neck dissection, and radioactive iodine (RAI) in 2006. Sixteen years later, she was found to have lung metastases and underwent a treatment dose of RAI. Given no improvement in her thyroglobulin levels, she underwent a third dose of RAI. One week following this, she presented with new ophthalmalgia, conjunctival injection, and binocular diagonal diplopia. She was diagnosed with a complex ophthalmoplegia, and a magnetic resonance imaging scan of her orbits revealed symmetric bilateral exophthalmos and bilateral enlargement of her extraocular muscles suggesting Graves ophthalmopathy. Her TSH receptor antibody was elevated at 10.1 IU/L (reference range, <1.8 IU/L), consistent with de novo Graves disease. We highlight the possibility that an overflow of TSH-receptor antigens following RAI treatment in patients with metastatic thyroid cancer can lead to the formation of TSH-receptor antibodies, presenting as Graves ophthalmopathy many years following total thyroidectomy.
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