Progressive evolution of thyroid adenoma to thyroid carcinoma

Aisyah Elliyanti


Nodules (adenomas), enlarged thyroid (goiter) and inflammation of the thyroid (thyroiditis) are the most important risk factors for thyroid cancer. Adenomas have the largest increase in risk. Objectives: to discuss two cases of adenomas goiter that became aggressive during follow-ups. Cases: Two patients, with an average age of 64 years, referred to Nuclear Medicine dr. M. Djamil Hospital in Padang for bone scintigraphy examination. Both patients had thyroid surgery and histopathology results were adenomas. However, after the removal surgery, the patients did not have proper follow-ups. Both patients developed pelvic pain. Bone scintigraphy showed an increase of radiopharmaceutical uptake at pelvic bones and computerized tomography (CT Scan) result showed destruction at the pelvic bone areas. Conclusions: These cases highlight the necessity for adenoma thyroid patients with a risk factor for thyroid cancer to have a complete follow-up program and sufficient length period.


thyroid cancer; bone metastasis; scintigraphy; thyroglobulin

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Cotran R, Kumar V, Collins T. Robbins Pathologic Basis of Disease. 6th Edition. Philadelphia: Saunders; 1999.

Katoh H, Yamashita K, Enomoto T, Watanabe M. Classification and General Considerations of Thyroid Cancer. Ann Clin Pathol. 2015; 3(1):1045. [Abstract/FREE Full Text].

Howell GM, Hodak SP, Yip L. RAS Mutations in Thyroid Cancer. Oncologist. 2013; 18(8):926-932. doi: 10.1634/theoncologist.2013-0072. [PMC free article].

Hoang J. Thyroid nodules and evaluation of thyroid cancer risk. Australas J Ultrasound Med. 2010; 13(4):33-36. doi: 10.1002/j.2205-0140.2010.tb00177.x. [PMC free article].

Kust D, Mateša N, Kusić Z. Clinical Significance of Multi-nodular in Patients with Papillary Thyroid Carcinoma. Anticancer Res. 2015; 35(11):6335-9. [PubMed] [Abstract/FREE Full Text].

Dom G, Frank S, Floor S, Kehagias P, Libert F, Hoang C, et al. Thyroid follicular adenomas and carcinomas: molecular profiling provides evidence for a continuous evolution. Oncotarget. 2018; 9(12):10343-10359. doi: 10.18632/oncotarget.23130. [PMC free article].

Gupta N, Dasyam AK, Carty SE, Nikiforova MN, Ohori NP, Amstrong M, et al. RAS mutations in thyroid FNA specimens are highly predictive of predominantly low-risk follicular-pattern cancers. J Clin Endorinol Metab. 2013; 98(5):E914-22. doi: 10.1210/jc.2012-3396. [PubMed].

McHenry CR, Phitayakorn R. Follicular Adenoma and Carcinoma of Thyroid Gland. Oncologist. 2011; 16(5):585-593. doi: 10.1634/theoncologist.2010-0405. [PMC free article].

Xing M. Clinical utility of RAS mutations in thyroid cancer: a blurred picture now emerging clearer. BMC Med. 2016; 14:12. doi: 10.1186/s12916-016-0559-9. [PubMed].