Paper # 019 Versión en Español Versión en Español

Dyshormonogenetic goiter. Presentation of a case.

Dres. María de la Vega, R. Camacho, B. Báez, J.L. Alfonso y A. Alonso.

Pathology Department. Hospital Nuestra Señora del Pino. Las Palmas de Gran Canaria. Spain.

Address: Hospital Nuestra Señora del Pino. C/ Ángel Guimera, 97
35004 Las Palmas de Gran Canaria. Spain

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Introduction. Dyshormonogenetic goiter is an entity due to the deficiency or structural abnormality in any of the enzymes playing a role in the thyroid hormones synthesis. It only represents a small percentage of all the goiters and very rarely it suffers a malignant transformation, but its histological and cytological features made its distinction from malignancy very difficult.

Case. We present a recent case of a 15 years old female diagnosed of goiter, with a family history of early thyroid pathology (grandmother, mother and aunt). After a cytological diagnosis of follicular tumor, she went on surgery in our institution.

Gross and histological study. We received a 31 gr. weight subtotal thyroidectomy in which we could identify 5 nodules, 4 of them of solid appearance; the other one was cystic, hemorragic. Microscopically none of them was encapsulated, and they were mostly composed of microfollicles, surrounded by fibrosis and brisk lymphocytic thyroiditis. Some of the follicle cells showed atypical nuclei. We reviewed her mother's and aunt's biopsies made at out hospital, and we found important similar histological findings.

Comments. Recognition of the peculiar histological and cytological findings in this entity may help to avoid an incorrect diagnosis of malignacy. In young patients diagonsed of goiter, we consider of high relevance the study of family history of thyroid pathology at a early age


Key Words: Goiter, Dyshormogenetic goiter, Thyroid nodule, Follicular tumor, Thyroidectomy

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