CRCM  Vol.3 No.8 , August 2014
Hyperthyroidism Due to Papillary Thyroid Carcinoma Associated with Ductal Breast Carcinoma
Abstract: Thyroid tumors are usually associated with euthyroidism, and hyper functioning tumors are rare. There are few reports of carcinomas associated with hyperthyroidism. The aim of this study is to describe a case of hyper functioning papillary carcinoma associated with breast carcinoma. We present a 46-year-old woman that was referred for investigation of thyroid and breast nodules detected by routine ultrasound. She presented with hyperthyroidism and enlarged left thyroid lobe with fibroelastic consistency. Investigation demonstrated papillary carcinoma with follicular hyperactivity and invasive ductal carcinoma of the breast. The patient developed metastases 6 months later and died. This study demonstrates that hot thyroid nodules may harbor malignant tumors and should be punctured. The association with breast adenocarcinoma and the unfavorable outcome suggest higher aggressiveness of this tumor in the presence of hyperthyroidism.
Cite this paper: Borges, M. , Modolo, I. , Modolo, R. , Silva, L. , Sato, L. , Tiveron, R. , Scandiuzzi, D. and Lima, M. (2014) Hyperthyroidism Due to Papillary Thyroid Carcinoma Associated with Ductal Breast Carcinoma. Case Reports in Clinical Medicine, 3, 479-486. doi: 10.4236/crcm.2014.38105.

[1]   Molnar, G.D., Childs, D.S. and Woolner, L.B. (1958) Histologic Evidence of Malignancy in a Thyroid Gland Bearing a “Hot” Nodule. The Journal of Clinical Endocrinology & Metabolism, 18, 1132-1134.

[2]   Bloise, W., Wajchenberg, B.L., Pieroni, R.R., Toledo, A.C., Mattar, E. and Cintra, A.B.U. (1963) Thyrotoxic Crisis and Electrolyte Disturbances in a Patient with Functioning Metastatic Carcinoma of the Thyroid: Chromatographic and Electrophoretic Studies. The Journal of Clinical Endocrinology & Metabolism, 23, 1096.

[3]   McConnon, J.K., Von Westarp, C. and Mitchell, R.I. (1975) Follicular Carcinoma of the Thyroid with Functioning Metastasis and Clinical Hypothyroidism. CMA Journal, 22, 724-727.

[4]   Cross, G.A., Suarez, H., Pitoia, F., Moncet, D., Vanegas, M., Bruno, O.D. and Niepomniszcze, H. (2008) Carcinoma and Graves Disease: Possible Implication of Cross-Signalling Mechanism. Arquivos Brasileiros de Endocrinologia & Metabologia, 52-57, 1194-1200.

[5]   Vini, L., Hyer, S., Brenda, P. and Harmer, C. (1989) Good Prognosis in Thyroid Cancer Found Incidentally at Surgery for Thyrotoxicosis. Thyroid Cancer, 75, 169-170.

[6]   Shands, W.C. and Gatling, R.R. (1970) Cancer of the Thyroid: Review of 109 Cases. Annals of Surgery, 171, 735-743.

[7]   Gabriele, R., Letizia, C., Borghese, M., De Toma, G., Celi, M., Izzo, L. and Carvallaro, A. (2003) Thyroid Cancer in Patients with Hyperthyroidism. Hormone Research in Paediatrics, 60, 79-83.

[8]   Terzioglu, T., Tezelman, S., Onaran, Y. and Tanakol, R. (1993) Concurrent Hyperthyroidism and Thyroid Carcinoma. British Journal of Surgery, 80, 1301-1302.

[9]   Russo, D., Tumino, S., Arturi, F., Vigneri, P., Grasso, G., Pontecorvi, A., Filetti, S. and Belfiore, A. (1997) Detection of an Activating Mutation of the Thyrotropin Receptor in a Case of an Autonomously Hyperfunctioning Thyroid Insular Carcinoma. The Journal of Clinical Endocrinology and Metabolism, 82, 735-738.

[10]   Claudine, A.L.S., Gedeon, P., Rosler, H., Minder, C., Netzer, P. and Laissue, J.A. (2002) Survival Analysis of 19 Patients with Toxic Thyroid Carcinoma. The Journal of Clinical Endocrinology & Metabolism, 87, 4122-4127.

[11]   Simon, M.S., Tang, M.T.C., Bernstein, L., Norman, S.A., Weiss, L., Burkman, R.T., Daling, J.R., Deapen, D., Folger, S.G., Malone, K., Marchbanks, P.A., McDonald, J.A., Strom, B.L., Wilson, H.G. and Spirtas, R. (2002) Do Thyroid Disorders Increase the Risk of Breast Cancer? Cancer Epidemiology, Biomarkers and Prevention, 11, 1574-1578.

[12]   Sandeep, T.C., Strachan, M.W., Reynolds, R.M., Brewster, D.H., Scilo, G., Pukkala, E., et al. (2006) Second Primary Cancers in Thyroid Cancer Patients: A Multinational Record Linkage Study. The Journal of Clinical Endocrinology & Metabolism, 91, 1819-1825.

[13]   Paul, S.J. and Sisson, J.C. (1990) Thyrotoxicosis Caused by Thyroid Cancer. Endocrinology and Metabolism Clinics of North America, 19, 593-612.

[14]   Holzapfel, H.P., Bergner, B., Wonerow, P. and Paschke, R. (2002) Expression of Gàs Proteins and TSH Receptor Signaling in Hyperfunctioning Thyroid Nodules with TSH Receptor Mutations. European Journal of Endocrinology, 147, 109-116.

[15]   Derwahl, M., Manole, D., Sobke, A. and Broecker, M. (1998) Pathogenesis of Toxic Thyroid Adenomas and Nodules: Relevance of Activating Mutations in the TSH-Receptor and Gàs Gene, the Possible Role of Iodine Deficiency and Secondary and TSH-Independent Molecular Mechanisms. Experimental and Clinical Endocrinology & Diabetes, 106, 56-59.

[16]   García-Jiménez, C. and Santisteban, P. (2007) TSH Signalling and Cancer. Arquivos Brasileiros de Endocrinologia & Metabologia, 51, 654-671.

[17]   Dulger, H., Alici, S., Agun, E., Etlik, O., Sayarlioglu, M., Iogãn, E., Sayarliogla, H. and Sekeroglu, M.R. (2004) Antithyroid Antibody Levels in Patients with Breast Cancer. European Journal of General Medicine, 1, 11-14.

[18]   Kuijpens, J.L.P., Nyklictek, I., Lowman, M.W.J., Weetman, T.A.P., Pop, V.J.M. and Coebergh, J.-W.W. (2005) Hypothyroidism Might Be Related to Breast Cancer in Post-Menopausal Women. Thyroid, 15, 1253-1259.

[19]   Turken, O., Narin, Y., Demirbas, S., Onde, M.E., Sayan, O., Kandemir, E.G., et al. (2003) Breast Cancer in Association with Thyroid Disorders. Breast Cancer Research, 5, R110-R113.

[20]   Gogas, J., KousKos, E., Tseleni-Balagouta, S., Markopoulos, C., Revenas, K., Gogas, G., et al. (2001) Autoimmune Thyroid Disease in Women with Breast Carcinoma. European Journal of Surgical Oncology, 27, 626-630.

[21]   Vorherr, H. (1987) Thyroid Function in Benign and Malignant Breast Disease. European Journal of Cancer and Clinical Oncology, 23, 255-257.

[22]   Saraiva, P., Figueiredo, N., Padovani, C., Brentani, M. and Nogueira, C. (2005) Profile of Thyroid Hormones in Breast Cancer Patients. Brazilian Journal of Medical and Biological Research, 38, 761-765.

[23]   Ron, E., Doody, M.M., Becker, D.V., Brill, A.B., Curtis, R.E., Goldman, M.B., Harris III, B.S.H., Hoffman, D.A., McConahey, W.M., Maxon, H.R., Preston-Martin, S., Warshaver, M.E., Wong, F.L. and Boice Jr., J.D. (1998) Cancer Mortality Following Treatment for Adult Hyperthyroidism. The Journal of the American Medical Association, 280, 347-355.

[24]   Hellevik, A.I., Asvold, B.O., Bjro, T., Romundstad, P.R., Nilsen, T.I. and Vatten, L.J. (2009) Thyroid Function and Cancer Risk: A Prospective Population Study. Cancer Epidemiology, Biomarkers & Prevention, 18, 570-574.

[25]   Nogueira, C.R. and Brentani, M.M.J. (1996) Triiodothyronine Mimics the Effects of Estrogen in Breast Cancer Cell Lines. The Journal of Steroid Biochemistry and Molecular Biology, 59, 271-279.

[26]   Dinda, S., Sanchez, A. and Mondgil, V. (2002) Estrogen-Like Effects of Thyroid Hormone on the Regulation of Tumor Suppressor Proteins, p 53 and Retinoblastoma, in Breast Cancer Cells. Oncogene, 21, 761-768.