Thyroid storm caused by metastatic papillary thyroid carcinoma tissue after total thyroidectomy: a case report
Thyroid storm is a life-threatening form of thyrotoxicosis and an endocrinological emergency. We present a case of thyroid storm in a patient with metastatic papillary thyroid cancer. A 67-year-old woman with a history of total thyroidectomy 4 years prior to presentation was admitted with deteriorat...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Yeungnam University College of Medicine, Yeungnam University Institute Medical Science
2023-11-01
|
| Series: | Journal of Yeungnam Medical Science |
| Subjects: | |
| Online Access: | http://www.e-jyms.org/upload/pdf/jyms-2023-00199.pdf |
| _version_ | 1797447961250103296 |
|---|---|
| author | So Hee Kwon Min-Ji Kim Sin Yeong Jung Jae-Han Jeon |
| author_facet | So Hee Kwon Min-Ji Kim Sin Yeong Jung Jae-Han Jeon |
| author_sort | So Hee Kwon |
| collection | DOAJ |
| description | Thyroid storm is a life-threatening form of thyrotoxicosis and an endocrinological emergency. We present a case of thyroid storm in a patient with metastatic papillary thyroid cancer. A 67-year-old woman with a history of total thyroidectomy 4 years prior to presentation was admitted with deteriorating mental status, fever, and tachycardia. Laboratory tests revealed severe thyrotoxicosis. Although the patient had no residual thyroid tissue after total thyroidectomy, she had a previously diagnosed metastatic thyroid cancer lesion in the pelvic bone. Despite initial treatment with a standard thyroid storm regimen, the patient died 6 days after hospitalization. The patient had no history of Graves disease; however, a thyroxine receptor antibody was detected postmortem. The patient had a history of exposure to an iodine contrast agent, which is a rare cause of thyrotoxicosis. Thyroxine production from a differentiated thyroid carcinoma is rare but can be a source of clinically significant thyrotoxicosis in patients post-thyroidectomy. Overlapping Graves disease is a common stimulus; however, other causes, such as exogenous iodine, cannot be excluded. This case demonstrates that in the setting of metastatic thyroid carcinoma, thyrotoxicosis cannot be completely ruled out as a cause of suspicious symptoms, even in patients with a history of total thyroidectomy. |
| first_indexed | 2024-03-09T14:03:29Z |
| format | Article |
| id | doaj.art-0678ad48352848ad86bb69bd2529074b |
| institution | Directory Open Access Journal |
| issn | 2799-8010 |
| language | English |
| last_indexed | 2024-03-09T14:03:29Z |
| publishDate | 2023-11-01 |
| publisher | Yeungnam University College of Medicine, Yeungnam University Institute Medical Science |
| record_format | Article |
| series | Journal of Yeungnam Medical Science |
| spelling | doaj.art-0678ad48352848ad86bb69bd2529074b2023-11-30T05:27:12ZengYeungnam University College of Medicine, Yeungnam University Institute Medical ScienceJournal of Yeungnam Medical Science2799-80102023-11-0140SupplS93S9710.12701/jyms.2023.001992784Thyroid storm caused by metastatic papillary thyroid carcinoma tissue after total thyroidectomy: a case reportSo Hee Kwon0Min-Ji Kim1Sin Yeong Jung2Jae-Han Jeon3 Department of Internal Medicine, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea Department of Internal Medicine, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Daegu, Korea Department of Internal Medicine, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, KoreaThyroid storm is a life-threatening form of thyrotoxicosis and an endocrinological emergency. We present a case of thyroid storm in a patient with metastatic papillary thyroid cancer. A 67-year-old woman with a history of total thyroidectomy 4 years prior to presentation was admitted with deteriorating mental status, fever, and tachycardia. Laboratory tests revealed severe thyrotoxicosis. Although the patient had no residual thyroid tissue after total thyroidectomy, she had a previously diagnosed metastatic thyroid cancer lesion in the pelvic bone. Despite initial treatment with a standard thyroid storm regimen, the patient died 6 days after hospitalization. The patient had no history of Graves disease; however, a thyroxine receptor antibody was detected postmortem. The patient had a history of exposure to an iodine contrast agent, which is a rare cause of thyrotoxicosis. Thyroxine production from a differentiated thyroid carcinoma is rare but can be a source of clinically significant thyrotoxicosis in patients post-thyroidectomy. Overlapping Graves disease is a common stimulus; however, other causes, such as exogenous iodine, cannot be excluded. This case demonstrates that in the setting of metastatic thyroid carcinoma, thyrotoxicosis cannot be completely ruled out as a cause of suspicious symptoms, even in patients with a history of total thyroidectomy.http://www.e-jyms.org/upload/pdf/jyms-2023-00199.pdfpapillary thyroid neoplasmsthyroid crisisthyrotoxicosis |
| spellingShingle | So Hee Kwon Min-Ji Kim Sin Yeong Jung Jae-Han Jeon Thyroid storm caused by metastatic papillary thyroid carcinoma tissue after total thyroidectomy: a case report Journal of Yeungnam Medical Science papillary thyroid neoplasms thyroid crisis thyrotoxicosis |
| title | Thyroid storm caused by metastatic papillary thyroid carcinoma tissue after total thyroidectomy: a case report |
| title_full | Thyroid storm caused by metastatic papillary thyroid carcinoma tissue after total thyroidectomy: a case report |
| title_fullStr | Thyroid storm caused by metastatic papillary thyroid carcinoma tissue after total thyroidectomy: a case report |
| title_full_unstemmed | Thyroid storm caused by metastatic papillary thyroid carcinoma tissue after total thyroidectomy: a case report |
| title_short | Thyroid storm caused by metastatic papillary thyroid carcinoma tissue after total thyroidectomy: a case report |
| title_sort | thyroid storm caused by metastatic papillary thyroid carcinoma tissue after total thyroidectomy a case report |
| topic | papillary thyroid neoplasms thyroid crisis thyrotoxicosis |
| url | http://www.e-jyms.org/upload/pdf/jyms-2023-00199.pdf |
| work_keys_str_mv | AT soheekwon thyroidstormcausedbymetastaticpapillarythyroidcarcinomatissueaftertotalthyroidectomyacasereport AT minjikim thyroidstormcausedbymetastaticpapillarythyroidcarcinomatissueaftertotalthyroidectomyacasereport AT sinyeongjung thyroidstormcausedbymetastaticpapillarythyroidcarcinomatissueaftertotalthyroidectomyacasereport AT jaehanjeon thyroidstormcausedbymetastaticpapillarythyroidcarcinomatissueaftertotalthyroidectomyacasereport |