Endocrinology and Metabolism

Case Report

A Case of Anterior Cervical Lipoma Mimicking Diffuse Goiter.: Eun Jig Lee, Moon Suk Nam, Su Youn Nam, Young Duk Song, Sung Kil Lim, Hyun Chul Lee, Kap Bum Huh, Kyung Rae Kim, Jun Sik Na, Yee Hyun Nam, Jeon Hong Kang, Jung Ki Seo; J Korean Endocr Soc. 1995;10(4):418-423. Published online November 7, 2019

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Abstract PDF: Lipoma is a benign fatty tumor that can arise in any location of the body where fat is present. It is found most commonly in the upper half of the body, particularly the head and neck, shoulders, and back. A mass in the antero-inferior part of the neck may be initially thought to be thyroid masses and then other cervical masses should be considered. Ultrasongraphic examination of benign lipoma demonstrates solid and echogenic mass and may differentiate nonthyroid from thyroid masses. Although the location of tumors, its consistency, and its motion with deglutition, seperation from the thyroid on sonographic examination, all pointed to nonthyroidal origin, did not rule out a possible mass that isolated from the lobes of the thyroid. Fine needle aspiration and biopsy can provide clear answer.We herein report a case of anterior cervical mass in a 48-yr-old male patient presenting a non-tender, slightly hard and nodular mass slowly growing for several years and moved with swallowing, and diagnosed his case as benign lipoma using thyroid scan and ultrasonography. When we encounter patients with anterior neck mass, we should consider benign lipoma mimicking diffuse goiter.

Original Articles

Amyloid Goiter.: Sung Rae Cho, Keun Yong Park, In Kyu Lee, Ki Lack Park, Seung Yeup Han, Young Woo Kang, Sung Bae Park, Hyun Chul Kim, Sang Pyo Kim, Kun Young Kwon; J Korean Endocr Soc. 1994;10(2):125-130. Published online November 6, 2019

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Abstract PDF: Amyloidosis is a systemic disorder of unknown etiology, The pathophysiological precess is caused by deposition of amyloid fibrils in tissues of the body. Almost any organ in the body can be affected, but amyloid goiter is a very rare presentation.A definitive diagnosis of amyloidosis requires tissue examination using special stains and electron microscopy. We had recently experienced a case of 62 year-old man who was found to have amyloid goiter after thyroid surgery.The patient was admitted Keimyung University Medical Center for evaluation of rapid growing thyroid mass and lobectomy of right thyroid gland was performed.The light microscopic finding showed eosinophilic hyalinized stroma containing one thick-walled blood wessel in the hematoxyline and eosin stain. Congo-red stain on polarized light showed apple-green birefringence of amyloid in thyroid and abdominal fat tissues. Using the PAP method, nodular deposits of amyloid in the stroma and blood vessels are stained positively with anti-AA serum. Electron microscopic finding showed randomly arranged and nonbranching fibrillary rods in the stroma.

Thyroid
The Association between Cobalt Deficiency and Endemic Goiter in School-Aged Children: Mojgan Sanjari, Ahmad Gholamhoseinian, Akram Nakhaee; Endocrinol Metab. 2014;29(3):307-311. Published online September 25, 2014; DOI: https://doi.org/10.3803/EnM.2014.29.3.307

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Background

In Iran, an iodine deficiency control program was initiated in 1989 by iodizing salt. Despite this program, goiters have remained an endemic condition in most parts of Iran. Thus, it is possible that other factors aside from iodine deficiency may contribute to endemic goiter. The aim of this study was to investigate the association between cobalt deficiency and endemic goiter in a region of Iran with a high prevalence of goiter.

Methods

A cross-sectional study was conducted among school children aged 9 to 11 years in the city of Kerman, Iran. In the first phase of the study, a multistage, proportional-to-size, cluster sampling method was used to screen 5,380 out of 29,787 students. After the screening phase, 170 students (130 goitrous and 40 nongoitrous) were randomly selected, and serum and urine specimens were obtained. We measured thyroid function, serum cobalt level, and urinary iodine excretion. Univariate and multiple logistic regression analyses were performed.

Results

The prevalence of grade 2 goiters was 34.8% (95% confidence interval [CI], 31.5 to 42.5), with both sexes being equally affected. The weight and body mass index of goitrous subjects was significantly lower (P<0.001) than those of nongoitrous subjects. The serum cobalt levels were lower in goitrous subjects than in nongoitrous subjects (4.4±2.9 µg/L vs. 6.4±2.7 µg/L). The urinary iodine levels were also lower in goitrous subjects than in nongoitrous subjects (198.3±108.3 µg/L vs. 270.2±91.1 µg/L). Multiple regression analysis showed that only cobalt deficiency, not iodine deficiency, significantly contributed to the presence of goiter (odds ratio, 0.78; 95% CI, 0.61 to 0.99; P=0.042).

Conclusion

Cobalt deficiency may be an important independent predicator for goiter in endemic regions, especially areas in which goiters persist despite salt iodization programs.

Citations

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Nádia M.P. Coelho, Filipe Bernardo, Armindo S. Rodrigues, Patrícia Garcia
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Assessment of trace element and mineral levels in students from Turkmenistan in comparison to Iran and Russia
Anatoly A. Kirichuk, Anatoly V. Skalny, Dirk Schaumlöffel, Irina A. Kovaleva, Tatiana V. Korobeinikova, Andrey S. Kritchenkov, Michael Aschner, Borhan Mansouri, Andrey A. Skalny, Alexey A. Tinkov
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Case Reports

A Case of Painful Graves' Disease.: Ji Yun Jeong, Tae Yong Kim, Eun Hee Kim, Eui Young Kim, Sang Ah Lee, Ji Hye Yim, Kyung Min Kim, Won Bae Kim, Young Kee Shong; J Korean Endocr Soc. 2008;23(5):337-341. Published online October 1, 2008; DOI: https://doi.org/10.3803/jkes.2008.23.5.337

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Abstract PDF

Graves' disease rarely presents as pain and tenderness of goiter, with only a few cases reported in the literature. We describe a case of painful Graves' disease presenting as 2 episodes of painful goiter.

Citations

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Painful goiter with persistent fever: a Graves' disease mimicking subacute thyroiditis
Amal MOUMEN, Amine KESSAB, Sara DERROU, Yousra BENABEDLFADIL, Somaya SAFI, Faycal EL GUENDOUZ
Chirurgia.2025;[Epub] CrossRef

A Case of Tracheal Adenoid Cystic Carcinoma Presenting with Diffuse Goiter.: Ho Cheol Kang, Seong Kyun Kim, Se Hoon Kang, Kyung Min Kim, Se In Hong, Dong Jin Chung, Min Young Chung, Joon Kyoo Lee, Sang Chul Lim, Jae Hyuk Lee; J Korean Endocr Soc. 2005;20(3):273-277. Published online June 1, 2005; DOI: https://doi.org/10.3803/jkes.2005.20.3.273

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Abstract PDF

A goiter is among the most common presenting symptoms of patients with thyroid diseases and is usually caused by intrinsic thyroid problems. While direct invasion of the trachea by aggressive thyroid tumors is a well-known phenomenon, the reverse situation, that is, a primary tracheal neoplasm invading by direct extension into the thyroid gland, presenting with a goiter is very rare. Here, a case of a tracheal adenoid cystic carcinoma(ACC), presenting with a diffuse goiter, is reported. A 47-year-old woman presented with slowly growing anterior neck swelling. A physical examination showed a diffuse firm goiter. The patient was euthyroiditic, and serum negative for thyroid autoantibodies. Thyroid ultrasonography and neck CT revealed a doughnut-shaped mass, encircling the trachea and displacing the thyroid anteriorly. Ultrasonography-guided fine needle aspiration(FNA) was compatible with an ACC, and a subsequent surgical resection confirmed the diagnosis. Although the occurrence of a tracheal ACC invading the thyroid is rare, this case highlights the need to be aware of unusual lesions arising in the region of the thyroid. This knowledge will help in making the correct cytological diagnosis when these lesions are sampled by FNA

Citations

Citations to this article as recorded by

Anesthetic challenges in tracheal resection and reconstruction in a patient with adenoid cystic carcinoma and retrosternal goiter
Jieyuan Chen, Songsong Mao
Indian Journal of Thoracic and Cardiovascular Surgery.2025; 41(10): 1460. CrossRef

Original Article

Regulatory Mechanism of p66 Shc Expression by TSH in FRTL-5 Cells.: Young Joo Park, Eun Shin Park, Tae Yong Kim, Yun Yong Lee, Seon Hwa Lee, Do Joon Park, Chan Soo Shin, Kyoung Soo Park, Seong Yeon Kim, Hong Kyu Lee, Bo Youn Cho; J Korean Endocr Soc. 2003;18(1):45-55. Published online February 1, 2003

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Abstract PDF: BACKGROUND
Thyroid goiters are very common, however, the mechanism of development is not fully understood. A TSH receptor has been known to activate two different signaling pathways the cAMP/protein kinase A(PKA) and phospholipase C(PLC)/protein kinase C(PKC) systems. However, both systems are limited in the degree to which they explain the discrepancy between a goiter and TSH receptor activation. It has recently been reported that the expression of p66 Shc was increased by TSH stimulation in thyrocytes, suggesting that the p66 Shc molecule may play a critical role in the transition of the TSH-induced growth signals. METHODS AND RESULTS: In this study, we examined the expression of p66 Shc by stimulation of TSH, and the regulatory mechanisms of the TSH-induced expression of the p66 Shc in FRTL-5 cells. In FRTL-5 cells, TSH could increase the expression of the p66 Shc, and the this expression was decreased to basal levels after the removal of TSH. The TSH-induced p66 Shc expression was competitively inhibited by TSH receptor blocking antibodies. The increments of the expression of the p66 Shc protein caused by TSH were both time and concentration dependent, and it was same in the mRNA levels. Cholera toxin increased the expression of the p66 Shc, while pertussis toxin did not. The activators of the cAMP/PKA pathway (8-bromo-cAMP and forskolin) also stimulated the expression of p66 Shc, and the PKA inhibitor H89 decreased the expression, while the inhibition of the PKC pathway by GF109203X, or PMA, affected the expression of p66 Shc very little. CONCLUSION: Our data suggests that p66 Shc may play an important role in regulating the growth of thyrocytes. The TSH receptor - Gs protein - adenylate cyclase - cAMP - PKA pathway mainly mediates the TSH effects on the expression of p66 Shc molecules.

Case Reports

Recurrence of Subacute Thyroiditis: Report of Two Cases.: Hyo Joong Yoon, Yong Ha Hwang, Ki Young Lee, Hong Kyu Kim, Hye Young Park, Moon Ho Kang; J Korean Endocr Soc. 2002;17(1):124-129. Published online February 1, 2002

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Abstract PDF: Subacute thyroiditis is a self-limited inflammatory disease of viral etiology. Patients of subacute thyroiditis usually recover completely with no sequelae and recurrences are infrequent. We report two cases of recurrent subacute thyroiditis. Case 1) A 21-year-old female visited the hospital for evaluation of neck pain. She had a history of antecedent upper respiratory infection, which had been followed for 10 days. She experienced heat intolerance, sweating, palpitation and tremor. On physical examination, her heart rate was 108/min and diffuse, firm and tender goiter was palpated. Thyrotoxicosis and decreased uptake on thyroid scan were found. We diagnosed subacute thyroiditis and she recovered with salicylate and beta blocker treatment. Two years later, she revisited our hospital with the same complaint. Typical findings of subacute thyroiditis were noticed. She recovered once more with the same treatment regimen. Case 2) A 54-year-old female visited the hospital for evaluation of neck pain. She had a history of antecedent upper respiratory infection, which was followed for 14 days. She experienced heat intolerance, sweating, palpitation and weight loss. On physical examination, her heart rate was 112/min and diffuse, firm and tender goiter was palpated. Thyrotoxicosis and decreased uptake on thyroid scan were found. We diagnosed subacute thyroiditis and recovered with prednisolone and beta blocker treatment. About eight months later, she revisited our hospital with the same complaint. Typical findings of subacute thyroiditis were noticed.We report two subjects who experienced recurrent episodes of subacute thyroiditis separated by periods of 24 and 8 months. These cases serve as a reminder that recurrence of subacute thyroiditis can occur.

Four Cases of Newly Developing Goiter During Lithium Carbonate Therapy.: Kwan Woo Lee, Young Goo Shin, Sung Keun Lee, Sung Kyu Lee, Yun Suk Chung, Hyun Man Kim; J Korean Endocr Soc. 1997;12(4):621-626. Published online January 1, 2001

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Abstract PDF: Since 1949, lithium has been widely used for treatment of manic depressive disorder. It has also been used for agranulocytosis after anticaneer chemotherapy and partially for hyperthyroidism. But it is well known that the long term administration of this drug is associated wih various antithyroid effects such as hypothyroidism, simple goiter, nodules and even thyrotoxicosis. Although the exact mechanism for leading hypothyroidism or goiter is still unknown, the incidence of lithium-induced hypothyroidism is 1-37% during lithium atment. We had an experience of newly developing goiter with or without hypothyroidism during lithium treatment in 4 MDP patients. Among our patients, the duration of lithium administration was from 0.7 months to 11 years, and the development of thyroid abnormality was impossible to predict. They were treated with thyroxine while lithium was discontinued causing favorable outcome. We suggest that routine thyroid function test include thyroid autoimmune antibody screening in patients planning to undergo lithium treatment.

A Case of Secondary Amyloid Goiter with Hypothyroidism.: Cheul Kag Park, Yeun Cheul Yang, Cheul Hee Lee, Jae Rak Jeong, Do Ha Kim, Jae Hee Suh, Jae Hoo Park, Young II Kim; J Korean Endocr Soc. 1999;14(4):752-756. Published online January 1, 2001

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Abstract PDF: Amyloidosis results from the deposition of insoluble, fibrous amyloid proteins, nearly always in the extracellular spaces of organs and tissues. There are several varieties of amyloidosis, each of which is identified by the immunochemical nature of amyloid protein fibrils. Amyloid goiter is a very rare clinical entity and can be confused with a neoplasm. We have experienced a case of amyloid goiter with hypothyroidism secondary to tuberculosis. A 20 years old women with 5 months history of pulmonary tuberculosis was admitted with complaints of diarrhea, abdominal pain, weight loss at one year ago. She had a non-tender, diffuse and firm goiter. Also she had normal thyroid function at the first admission but was found to be hypothyroid at the second admission, 10 months later. Histologic examination revealed amyloid deposition in thyroid gland, stomach, colon and rectum.

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