Diagnosis and course
The finding of a low radio-iodine uptake into the palpable nodule suggests that
a thyroid neoplasm might be present. A tissue diagnosis is needed to fully evaluate that
possibility, so a fine needle aspirate (FNA) of the nodule was made and the cytology
of the recovered cells was examined.
The diagnosis from the FNA was papillary carcinoma of the thyroid, and the final diagnosis for
the patient was:
Grave's disease with papillary carcinoma
Course
The patient underwent surgical thyroidectomy followed by thyroid hormone replacement therapy.
Later, he was scanned for residual thyroid tissue, which was ablated with iodine-131.
He underwent periodic serum thyroglobulin analysis and iodine-131 scans, which remained negative over a two-year course.
Recently, ocular tearing and itching with proptosis were noted on physical exam.
Questions
Are these ocular symptoms suggestive of a recurrent thyroid problem (e.g., recurrent tumor) in this patient?
