A Case of Marine-Lenhart Syndrome with a Hyalinizing Trabecular Tumor Located in an Autonomous Hyperfunctioning Thyroid Nodule

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 75; no. 8; pp. 2110 - 2113
• Main Authors: KOKUBO, Kentaro, HAYASHI, Masatoshi, TOCHII, Koya, TAKAHASHI, Kei, MATSUMOTO, Mitsuyoshi
• Format: Journal Article
• Language: Japanese
• Published: Japan Surgical Association 2014
• Subjects: hyalinizing trabecular tumor; Marine–Lenhart syndrome; Plummer's disease
• ISSN: 1345-2843; 1882-5133
• DOI: 10.3919/jjsa.75.2110

A 61-year-old woman presented with a two-month history of general fatigue and body weight loss. She was transferred to our hospital from another hospital because her laboratory test results indicated hyperthyroidism. The left lobe of her thyroid gland was swollen, and a solitary nodule (90 × 38 mm) could be palpated in the left thyroid lobe and shift of the trachea. The patient's thyroid function tests revealed high levels of free T3 and free T4 and low TSH secretion. She tested positive for the TSH receptor antibody (third generation). A thyroid scan with 99mTc showed a diffused enlarged gland with increased uptake and greater uptake in the left nodule. On the basis of these findings, a diagnosis of Marine-Lenhart syndrome (coexistence of Graves' disease and an autonomous hyperfunctioning thyroid nodule) was made. Subtotal thyroidectomy was performed. Since immunostaining revealed positivity for type IV collagen, laminin, and MIB-1, we diagnosed this case as an unusual presentation of Marine-Lenhart syndrome with a hyalinizing trabecular tumor located in the autonomous hyperfunctioning thyroid nodule.