Case Report ARTICLE
Breakdown of autonomously functioning thyroid nodule accompanied by acromegaly after octreotide treatment
- 1Division of Diabetes and Obesity, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
Patients with acromegaly are at increased risk of developing certain tumors, including goiter and thyroid nodules, and occasionally autonomous thyroid nodules. A 53-year-old woman presented at our hospital with untreated acromegaly. She had typical physical features of acromegaly with pituitary adenoma, and thyrotoxicosis with thyroid-stimulating hormone suppression was also confirmed. Thyroid ultrasonography and scintigraphy showed an autonomously functioning thyroid nodule on her right lobe. Because her thyrotoxicosis was mild, she was initially treated with octreotide for acromegaly. However, 1 month after octreotide administration, she developed neck pain and fever with transient thyrotoxicosis. The blood flow around the nodule then decreased and the excess trapping of isotope detected by scintigraphy was reduced, followed by normalization of insulin-like growth factor-1 levels and thyroid function. This case suggests that octreotide may have unexpected effects on autonomous thyroid nodules. However, further studies are needed to determine the clinical course of autonomously functioning thyroid nodules, including thyroid function and tumor manifestations, during octreotide therapy.
Keywords: Autonomously functioning thyroid nodule, Acromegaly, somatostatin analog, pituitary adenoma, Thyrotoxicosis
Received: 20 Apr 2018;
Accepted: 12 Feb 2019.
Edited by:Mônica Gadelha, Federal University of Rio de Janeiro, Brazil
Reviewed by:Luiz E. Wildemberg, Instituto Estadual do Cérebro Paulo Niemeyer, Brazil
Renata S. Auriemma, University of Naples Federico II, Italy
Copyright: © 2019 Nomoto, Kameda, Nakamura, Tsuchida, Nagai, Atsumi and Miyoshi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Dr. Hideaki Miyoshi, Hokkaido University, Division of Diabetes and Obesity, Faculty of Medicine and Graduate School of Medicine, Sapporo, 060-8638, Hokkaido, Japan, email@example.com