Medullary thyroid cancer, papillary thyroid microcarcinoma and Graves' disease: An unusual clinical coexistence

G. Mazziotti, M. Rotondi, G. Manganella, R. Franco, P. F. Rambaldi, S. Capone, V. Colantuoni, G. Amato, C. Carella

Research output: Contribution to journalArticlepeer-review


We describe the unusual case of a Caucasian woman who had a diagnosis of medullary thyroid cancer and papillary microcarcinoma 5 years after a diagnosis of Graves' disease. The patient came to our observation for recurrence of hyperthyroidism. An ultrasound scan revealed diffuse thyroid enlargement with a nodule, recently increased in size. The serum CT and carcinoembrional antigen were elevated, and the fine-needle aspiration cytology with immunocytochemical analysis for CT was suggestive for medullary thyroid carcinoma. The nodular lesion showed intense 111In-pentetreotide uptake, whereas total body scintigraphy with the same tracer and with Thallium-201, 99mTc (V) dimercaptosuccinic acid was negative for lymph node and distant metastasis. The histological examination of thyroidectomy specimens confirmed the diagnosis of medullary thyroid cancer, showing a lymphocytic intratumoral infiltration. The histological analysis of the controlateral lobe showed an occult papillary microcarcinoma. Medullary thyroid carcinoma and papillary microcarcinoma showed intense staining with policlonal anti-RET antibodies, although genetic analysis was negative for RET mutations most frequently involved in familial and sporadic medullary thyroid carcinomas. Possible implications about the coexistence of the 3 thyroid diseases are discussed.

Original languageEnglish
Pages (from-to)892-896
Number of pages5
JournalJournal of Endocrinological Investigation
Issue number11
Publication statusPublished - 2001


  • Graves' disease
  • Medullary thyroid carcinoma
  • Papillary thyroid carcinoma

ASJC Scopus subject areas

  • Endocrinology


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