Spontaneous Remission Of Metastatic Paraganglioma

Abstract

In order to increase our knowledge of the natural history of autonomous hyperfunctioning thyroid adenoma (AHTA), we describe eight cases of spontaneous regression or resolution, which we selected from a group of ninety-four cases with different evolutions. The patients were examined between 1969 and 1976. With regard to the evolution of the nodules two kinds of behavior have been distinguished: regression, i. e., AHTA which lowered its degree of autonomous hyperfunction and which thereafter regrew with different activity in comparison with extranodular tissue; resolution, i.e., AHTA which regressed and never recovered during our observation. When first examined, six of the eight patients (six women and two men) were found to be euthyroid, and two slightly hyperthyroid. Three of the euthyroid patients were shown, on the scintigram, to have a ‘hot’ nodule and three a ‘warm’ one. The two hyperthyroid patients had ‘warm’ nodules which were noticeably larger than those of the others. In the cases of persistent euthyroidism, the regression or resolution was established by means of scintigraphy after a period varying from one to about four years. One of the cases with an initial ‘warm’ nodule developed a ‘hot’ nodule about two years after regression. In the two slightly hyperthyroid cases, the resolution of the nodule coincided with the disappearance of the symptoms. These cases show and confirm the evolution of AHTA towards regression or resolution. In our patients this evolution was more frequent in the cases of autonomous nodules which on the initial scintigram showed the greatest dishomogeneity of distribution radioactivity within the thyroid nodule. When the regression or resolution of AHTA occurs without the characteristic symptoms of haemorrhagic infarction of the adenoma, it can only be ascertained by means of scanning and/or in-vitro thyroid function tests.