Papillary thyroid carcinoma with thyroid-associated orbitopathy in a euthyroid state

Jinsook Yoon, Helen Lew, Jeong Soo Park, Ki Hyun Nam, Sang Yeul Lee

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

PURPOSE: Thyroid cancers with concurrent thyroid-associated orbitopathy (TAO) are extremely rare. The present study reports 5 unusual cases of papillary thyroid microcarcinoma in patients presenting with TAO in an euthyroid state. METHODS: We retrospectively reviewed the records of 5 patients (4 female, 1 male) with no known history of thyroid disease, who initially presented with TAO and were subsequently found to have thyroid cancer. TAO was diagnosed by a combination of computed tomography and clinical symptoms and signs. All patients underwent routine serologic assessment of thyroid hormones and thyroid-related autoantibodies including thyrotropin-receptor antibodies, as well as imaging studies such as neck ultrasonography or thyroid scintiscan with I. RESULTS: Patients presented with asymmetric proptosis (cases 1-3), ocular motility restriction (cases 1-3), and eyelid retraction (cases 1-5). None of the patients showed clinical signs of hyperthyroidism, and all returned normal thyroid function test data. Thyroid nodules were detected by neck imaging; subsequent fine-needle aspiration biopsies were performed with the cytologic result of papillary carcinoma. In no cases did ophthalmic symptoms resolve following cancer treatment (e.g., thyroidectomy and radioactive iodine therapy). All patients were positive for thyroid-binding inhibiting immunoglobulin in low titers. CONCLUSIONS: Although coincident occurrence is rare, patients presenting with TAO should be carefully evaluated for the possible presence of papillary microcarcinoma, which can develop in a setting of systemic autoimmunity without inducing hyperthyroidism.

Original languageEnglish
Pages (from-to)187-191
Number of pages5
JournalOphthalmic Plastic and Reconstructive Surgery
Volume23
Issue number3
DOIs
Publication statusPublished - 2007 May 1

Fingerprint

Thyroid Gland
Hyperthyroidism
Thyroid Neoplasms
Neck
Thyroid Function Tests
Thyrotropin Receptors
Thyroid Nodule
Exophthalmos
Papillary Thyroid cancer
Papillary Carcinoma
Thyroid Diseases
Thyroidectomy
Eyelids
Fine Needle Biopsy
Autoimmunity
Thyroid Hormones
Iodine
Autoantibodies
Signs and Symptoms
Immunoglobulins

All Science Journal Classification (ASJC) codes

  • Surgery
  • Ophthalmology

Cite this

Yoon, Jinsook ; Lew, Helen ; Park, Jeong Soo ; Nam, Ki Hyun ; Lee, Sang Yeul. / Papillary thyroid carcinoma with thyroid-associated orbitopathy in a euthyroid state. In: Ophthalmic Plastic and Reconstructive Surgery. 2007 ; Vol. 23, No. 3. pp. 187-191.
@article{0e1bc110597c4ba7a48a93c5cdf03c21,
title = "Papillary thyroid carcinoma with thyroid-associated orbitopathy in a euthyroid state",
abstract = "PURPOSE: Thyroid cancers with concurrent thyroid-associated orbitopathy (TAO) are extremely rare. The present study reports 5 unusual cases of papillary thyroid microcarcinoma in patients presenting with TAO in an euthyroid state. METHODS: We retrospectively reviewed the records of 5 patients (4 female, 1 male) with no known history of thyroid disease, who initially presented with TAO and were subsequently found to have thyroid cancer. TAO was diagnosed by a combination of computed tomography and clinical symptoms and signs. All patients underwent routine serologic assessment of thyroid hormones and thyroid-related autoantibodies including thyrotropin-receptor antibodies, as well as imaging studies such as neck ultrasonography or thyroid scintiscan with I. RESULTS: Patients presented with asymmetric proptosis (cases 1-3), ocular motility restriction (cases 1-3), and eyelid retraction (cases 1-5). None of the patients showed clinical signs of hyperthyroidism, and all returned normal thyroid function test data. Thyroid nodules were detected by neck imaging; subsequent fine-needle aspiration biopsies were performed with the cytologic result of papillary carcinoma. In no cases did ophthalmic symptoms resolve following cancer treatment (e.g., thyroidectomy and radioactive iodine therapy). All patients were positive for thyroid-binding inhibiting immunoglobulin in low titers. CONCLUSIONS: Although coincident occurrence is rare, patients presenting with TAO should be carefully evaluated for the possible presence of papillary microcarcinoma, which can develop in a setting of systemic autoimmunity without inducing hyperthyroidism.",
author = "Jinsook Yoon and Helen Lew and Park, {Jeong Soo} and Nam, {Ki Hyun} and Lee, {Sang Yeul}",
year = "2007",
month = "5",
day = "1",
doi = "10.1097/IOP.0b013e31803e1755",
language = "English",
volume = "23",
pages = "187--191",
journal = "Ophthalmic Plastic and Reconstructive Surgery",
issn = "0740-9303",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

Papillary thyroid carcinoma with thyroid-associated orbitopathy in a euthyroid state. / Yoon, Jinsook; Lew, Helen; Park, Jeong Soo; Nam, Ki Hyun; Lee, Sang Yeul.

In: Ophthalmic Plastic and Reconstructive Surgery, Vol. 23, No. 3, 01.05.2007, p. 187-191.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Papillary thyroid carcinoma with thyroid-associated orbitopathy in a euthyroid state

AU - Yoon, Jinsook

AU - Lew, Helen

AU - Park, Jeong Soo

AU - Nam, Ki Hyun

AU - Lee, Sang Yeul

PY - 2007/5/1

Y1 - 2007/5/1

N2 - PURPOSE: Thyroid cancers with concurrent thyroid-associated orbitopathy (TAO) are extremely rare. The present study reports 5 unusual cases of papillary thyroid microcarcinoma in patients presenting with TAO in an euthyroid state. METHODS: We retrospectively reviewed the records of 5 patients (4 female, 1 male) with no known history of thyroid disease, who initially presented with TAO and were subsequently found to have thyroid cancer. TAO was diagnosed by a combination of computed tomography and clinical symptoms and signs. All patients underwent routine serologic assessment of thyroid hormones and thyroid-related autoantibodies including thyrotropin-receptor antibodies, as well as imaging studies such as neck ultrasonography or thyroid scintiscan with I. RESULTS: Patients presented with asymmetric proptosis (cases 1-3), ocular motility restriction (cases 1-3), and eyelid retraction (cases 1-5). None of the patients showed clinical signs of hyperthyroidism, and all returned normal thyroid function test data. Thyroid nodules were detected by neck imaging; subsequent fine-needle aspiration biopsies were performed with the cytologic result of papillary carcinoma. In no cases did ophthalmic symptoms resolve following cancer treatment (e.g., thyroidectomy and radioactive iodine therapy). All patients were positive for thyroid-binding inhibiting immunoglobulin in low titers. CONCLUSIONS: Although coincident occurrence is rare, patients presenting with TAO should be carefully evaluated for the possible presence of papillary microcarcinoma, which can develop in a setting of systemic autoimmunity without inducing hyperthyroidism.

AB - PURPOSE: Thyroid cancers with concurrent thyroid-associated orbitopathy (TAO) are extremely rare. The present study reports 5 unusual cases of papillary thyroid microcarcinoma in patients presenting with TAO in an euthyroid state. METHODS: We retrospectively reviewed the records of 5 patients (4 female, 1 male) with no known history of thyroid disease, who initially presented with TAO and were subsequently found to have thyroid cancer. TAO was diagnosed by a combination of computed tomography and clinical symptoms and signs. All patients underwent routine serologic assessment of thyroid hormones and thyroid-related autoantibodies including thyrotropin-receptor antibodies, as well as imaging studies such as neck ultrasonography or thyroid scintiscan with I. RESULTS: Patients presented with asymmetric proptosis (cases 1-3), ocular motility restriction (cases 1-3), and eyelid retraction (cases 1-5). None of the patients showed clinical signs of hyperthyroidism, and all returned normal thyroid function test data. Thyroid nodules were detected by neck imaging; subsequent fine-needle aspiration biopsies were performed with the cytologic result of papillary carcinoma. In no cases did ophthalmic symptoms resolve following cancer treatment (e.g., thyroidectomy and radioactive iodine therapy). All patients were positive for thyroid-binding inhibiting immunoglobulin in low titers. CONCLUSIONS: Although coincident occurrence is rare, patients presenting with TAO should be carefully evaluated for the possible presence of papillary microcarcinoma, which can develop in a setting of systemic autoimmunity without inducing hyperthyroidism.

UR - http://www.scopus.com/inward/record.url?scp=34249101574&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34249101574&partnerID=8YFLogxK

U2 - 10.1097/IOP.0b013e31803e1755

DO - 10.1097/IOP.0b013e31803e1755

M3 - Article

VL - 23

SP - 187

EP - 191

JO - Ophthalmic Plastic and Reconstructive Surgery

JF - Ophthalmic Plastic and Reconstructive Surgery

SN - 0740-9303

IS - 3

ER -