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Exp Clin Endocrinol Diabetes 2009; 117(5): 234-239
DOI: 10.1055/s-0028-1102920
Case Report

© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Differentiated Thyroid Carcinoma (DTC) in a Young Woman with Peutz-Jeghers Syndrome: Are these Two Conditions Associated?

L. Zirilli 1 , P. Benatti 2 , S. Romano 1 , L. Roncucci 2 , G. Rossi 1 , 2 , C. Diazzi 1 , C. Carani 1 , M. Ponz De Leon 2 , V. Rochira 1
  • 1Chair of Endocrinology, Integrated Department of Medicine, Endocrinology and Metabolism, and Geriatrics, University of Modena and Reggio Emilia, Modena, Italy
  • 2Department of Medicine and Medical Specialties, University of Modena and Reggio Emilia, Modena, Italy
Further Information

Publication History

received 04.12.2007 first decision 11.04.2008

accepted 14.08.2008

Publication Date:
20 February 2009 (online)

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Abstract

Aims: Peutz-Jeghers Syndrome (PJS) is a rare dominantly inherited disease characterized by hamartomatous small bowel polyposis, mucocutaneous hyperpigmentation, and increased risk of cancer. Differentiated thyroid cancers (DTCs) present mainly as sporadic, but they may have also a familial component. We present a case of PJS in a caucasian 25 years-old woman, who developed a DTC.

Methods: The patient had a palpable nodule in the right side of the thyroid region and an endocrinological evaluation, including hormonal assays, neck ultrasound (US) and fine needle aspiration (FNAB) of the nodule was performed.

Results: US confirmed a single nodular lesion in the right thyroid lobe (14 mm). Cytological analysis at FNAB revealed a pattern compatible with papillary thyroid carcinoma. The histological analysis after total thyroidectomy confirmed the diagnosis of a Hurtle cell variant of papillary thyroid carcinoma, with follicular architecture.

Conclusion: Even though rare, the association between PJS and DTC can be possible. In clinical practice it must be borne in mind that the wide spectrum of possible cancer diseases occurring in PJS could also include DTC, that the latter can occur earlier in life in PJS population and with a more aggressive histological pattern. Furthermore, in patients with PJS, US of the thyroid should be performed whenever thyroid disease is suspected at physical examination or based on patient's medical history. Due to lack of established data allowing for a real esteem of the association between PJS and DTC, US of the thyroid, should not be recommended as a routine screening for all subjects with PJS.

Key words

Peutz-Jeghers syndrome - differentiated thyroid cancer - hamartomatous polyposis - thyroid nodules - familial adenomatous syndrome

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Correspondence

V. RochiraMD, PhD 

Chair of Endocrinology

Department of Medicine, Endocrinology and Metabolism, and Geriatrics

University of Modena and Reggio Emilia

Ospedale S.Agostino-Estense di Baggiovara

Via Giardini 1355

Baggiovara

Modena

Italy

Phone: +39/059/4222 45 29

Phone: +39/059/396 18 16

Fax: +39/059/396 13 35

Email: rochira.vincenzo@unimore.it