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Yi, Baek, Son, and Kang: A Case of Subacute Thyroiditis Associated with Papillary Thyroid Carcinoma and Takayasu's Arteritis
Case Report
Endocrinology and Metabolism

Endocrinology and Metabolism 2011; 26(4): 324-329.

Published online: 21 December 2011

DOI: https://doi.org/10.3803/EnM.2011.26.4.324

A Case of Subacute Thyroiditis Associated with Papillary Thyroid Carcinoma and Takayasu's Arteritis

Dongwon Yi, Seung Hoon Baek1, Seok Man Son, Yang Ho Kang

Department of Internal Medicine, Pusan National University School of Medicine, Yangsan, Korea.

1Divisions of Endocrinology and Metabolism, Rheumatology, Pusan National University School of Medicine, Yangsan, Korea.

Corresponding author: Yang Ho Kang. Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, 20 Geumo-ro, Mulgeum-eup, Yangsan 626-770, Korea. Tel: +82-55-360-2358, Fax: +08-55-360-1565, kangyh@pusan.ac.kr

Received 20 March 2011       Accepted 23 May 2011

Copyright © 2011 Korean Endocrine Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Subacute thyroiditis is a self-limiting inflammation of the thyroid, presenting with painful thyroid swelling, thyrotoxicosis and low radioactive iodine uptake. The characteristic US findings for this disease are focal ill-defined hypoechoic areas in one lobe or diffuse hypoechoic areas in both lobes. Thyroid carcinomas should be included in the differential diagnosis for a lesion with focal hypoechoic areas and have been rarely reported to coexist with subacute thyroiditis. Takayasu's arteritis is an autoimmune disease that affects the aorta and its branches as well as pulmonary arteries. Subacute thyroiditis associated with Takayasu's arteritis is extremely rare, with only three cases being reported. We report here on the first case with the simultaneous diagnosis of subacute thyroiditis, papillary thyroid carcinoma and Takayasu's arteritis.

Keywords: Papillary thyroid carcinoma, Subacute thyroiditis, Takayasu's arteritis

Figures and Tables

Fig. 1
Ultrasonogram. A. Left thyroid sonogram shows a focal ill-defined hypoechoic area. B. Right thyroid sonogram shows a 1.1 × 0.8 × 0.9 cm sized hypoechoic solid nodule with micro/macrocalcifications. C. Transverse sonogram of the left common carotid artery shows concentric wall thickening. D. Longitudinal sonogram of the left common carotid artery shows long segmental wall thickening.
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Fig. 2
Thyroid scan. 99mTc O4 thyroid scan shows markedly decreased uptake in thyroid area.
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Fig. 3
3D computed tomography angiography. A. It shows circumferential thickening of the wall of the descending thoracic aorta. B. It shows total occlusion in long segment of proximal portion of the left subclavian artery.
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Fig. 4
Conventional angiography. A. It shows occlusion of proximal portion of the left subclavian artery at just distal portion of the left thyrocervical artery. B. There are numerous collateral circulations supplying the distal portion of the left subclavian artery.
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Fig. 5
Pathology of the resected thyroid. A. There is papillary growth pattern represented by finger-like projections lined by neoplastic cells (H&E stain, × 400). B. It shows focal infiltration of inflammatory cells (H&E stain, × 400). C. It shows mild interstitial fibrosis (H&E stain, × 40).
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