Unexpected conversion from hypothyroidism to an euthyroid state due to Graves' disease in a patient with an ectopic thyroid

Endocrine. 2014 Aug;46(3):684-5. doi: 10.1007/s12020-013-0117-6. Epub 2013 Nov 27.

Abstract

A 15-year-old woman was diagnosed with hypothyroidism and unilateral ectopic thyroid. Levothyroxine treatment was introduced; however, the patient was non-compliant and took the medication irregularly. When she presented to an endocrinologist at the age of 30, she had not been using levothyroxine for at least 6 months. Surprisingly, she was clinically and biochemically euthyroid. Due to decreased echogenicity on ultrasound examination, enhanced vascularization on Color Doppler examination and increased concentration of anti-TSH receptor autoantibodies, she was diagnosed with Graves' disease. Eventually, she underwent total thyroidectomy due to diagnosis of follicular neoplasm in fine-needle aspiration biopsy of the focal lesion found in the thyroid gland. To our knowledge, our patient is the first described with ectopic thyroid, presenting a nodular variant of Graves' disease and no signs of orbitopathy, who was initially hypothyroid and became euthyroid in the course of autoimmune thyroid disease.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antithyroid Agents / blood*
  • Antithyroid Agents / therapeutic use
  • Female
  • Graves Disease / blood*
  • Graves Disease / surgery
  • Humans
  • Hypothyroidism / blood*
  • Hypothyroidism / drug therapy
  • Thyroid Dysgenesis / blood*
  • Thyroid Dysgenesis / drug therapy
  • Thyroidectomy
  • Thyroxine / therapeutic use
  • Treatment Outcome

Substances

  • Antithyroid Agents
  • Thyroxine