Spontaneous Disappearance Of An Atypical Hürthle Cell Adenoma
American Journal of Clinical Pathology 80(3): Sep 1983; 399-402
View Original Source →Abstract
In a letter, the author reports a case of spontaneous resolution of phaeochromocytoma. This has never previously been reported except in the setting of haemorrhagic necrosis, the outcome normally being fatal in these cases. This case documents the spontaneous remission of phaeochromocytoma, with reversal of cardiac failure and the return of heart size to normal. This remission has been documented by the return of the catecholamines to normal, the blood pressure to normal and the calcification of the adrenal lesion on CT scan.
Case Details
Personal Characteristics
23 1/2-year-old male
Clinical Characteristics
An easily palpable 5.5 x 2.3 centimeter nonfunctioning nodule. No signs or symptoms of hyperthyroidism or hypothyroidism. Firm, nontender, smooth mass in the lateral part of the right lobe. The 24-hour uptake of radioiodide was 29%. The mass was hypofunctioning and intruded into the normal tissue. The fixed smears were stained ultimately by the papanicolaou technic. The cells were large, polyhedral, or oval, with typical eosinophilic granules in the cytoplasm. The nuclei were prominent, with a fairly prominent nuclear membrane and a distinct nucleolus but with a relatively low n/c ratio.
Remission Characteristics
The mass was smaller the day after the fnab and continued to shrink, until, by the 26th day, it no longer was felt. The 24-hour uptake of radioiodide was 26%, and the scan now disclosed a normal bilobed thyroid gland with no trace of the original nodule.
Treatment & Mechanisms
Proposed Remission Mechanisms
Not discussed
Clinical Treatment
A fnab with a 25-gauge needle was performed. Five passes in different parts of the nodule yielded similar material.
Additional Notes
The patient decided not to take any of the prescribed 1-thyroxine. The patient was examined again on December 16, 1982, 17 months after the FNAB. Once again, the thyroid gland barely was felt, so that there was no lesion available for an FNAB. The 24-hour uptake of radioiodide was 30%, and the scan revealed a normal bilobed thyroid gland with homogeneous distribution of the radioiodide without any suggestive straightening of the lateral margin of the right lobe as in the scan of October 17, 1981.