Gennaio 2016 - Volume XXXV - numero 1
Pagine elettroniche
Indirizzo per corrispondenza: federico.marchetti@ausl.ra.it
Key words: Thymic hyperplasia, Graves’ disease, Case report
The case of a 10-year-old girl with clinical hypothyroidism in substitution treatment is described. After the onset of symptoms suggestive of mediastinal mass associated with evolution in hyperthyroidism, she was diagnosed with thymic hyperplasia in Graves’ disease. The mass regressed after antithyroid treatment. Thymic hyperplasia is a benign condition that can be associated with Graves’ disease even if symptomatic massive enlargement is rare. The pathogenesis is not well understood. Antithyroid drugs usually lead to regression, therefore a correct diagnosis by using imaging techniques (echography, MRI, and CT), is essential to avoid unnecessary surgical procedures.
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Pagine elettroniche
1UOC di Pediatria, 2UOC di Radiologia, AO Bolognini, Seriate (BG)
Indirizzo per corrispondenza: moirapinotti@yahoo.it
Key words: Graves’ disease, Fine needle aspiration citology, Papillary thyroid carcinoma, Case report
Graves’ disease in children is rare; for this reason and for the insidious clinical presentation, the diagnosis is difficult, especially when there are not risk factors that orient the clinician. The paper reports the case of a 15-year-old boy with non-contributory familiar and personal history. Three months after weight loss, clinical and laboratory data permitted to make a diagnosis of Graves’ disease. A 5 mm thyroid nodule and the ultrasound features of cervical lymph nodes led to further diagnosis: fine needle aspiration cytology of a lymph node confirmed metastasis of papillary thyroid carcinoma. After 9 months from the first therapeutic intervention, the cancer showed an aggressive evolution with cervical lymph nodes relapse. The right attention to the clinical and ultrasound data allowed the identification of this rare association of pathologies also in a paediatric department of first level; the difficult follow up should be entrusted to a center with proven experience and with a multidisciplinary team.
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