JOURNAL OF THE LOUISIANA STATE MEDICAL SOCIETY
PATIENT 2
Patient was a 14 year old male referred to Endocrinology for evaluation of elevated TSH: 5.97 uIU/mL (0.3-4), normal total T4:7.9 ug/dL (5.6-11.7), and suspected thyroid nodule discovered during work up for obesity. He had no family history or symptoms of thyroid disease. US did not reveal a nodule, but scattered small multiple cysts were found. This patient was lost to follow up after the initial evaluation. Ultrasound findings are presented in the middle of the Figure.
PATIENT 3
Patient was a 14 year 2 month old female with Gorlin-Goltz syndrome (nevoid basal cell carcinoma syndrome) confirmed genetically after occurrence of ovarian tumors and multiple skin nevi. PCT was identified upon ultrasound imaging of the neck for evaluation of a left post-auricular lymph node and a small skin mole in the same area. The patient had a family history significant for Graves disease in two of her maternal aunts. Patient had no symptoms of thyroid disease. On physical exam no goiter or thyroid nodules were identified. Due to her mild thyroid enlargement and multiple cysts on ultrasound, she was started on levothyroxine therapy. Subsequent imaging over three years of follow up has shown no change in thyroid or cyst sizes. She continues to have negative thyroid specific anti- bodies. Ultrasound findings are presented at the bottom of the Figure.
PATIENT 4
Patient was a 14 year 5month oldmale referred to endocrinology for evaluation of multiple thyroid cysts incidentally found during CT imaging of the neck after an automobile accident. He was otherwise healthy and without thyroid symptoms. Mother and maternal grandmother have a history of hypothyroidism of unclear etiology. Physical exam was normal. Over 24 months this patient has not had change in thyroid status.
Figure. Thyroid ultrasound in patients 1 (top), 2 (middle), and 3 (bottom) are representative of the ultrasounds in all patients.
PATIENT 5
PATIENT 1
Patient was a 12 year old male referred to Endocrinology for evaluation of a goiter. Patient denied symptoms of thyroid disease except weight gain of 12 pounds in the prior year. His past medical history is significant for cyclic neutropenia. Physical exam was significant for weight >95th percentile, and barely palpable thyroid gland with normal consistency and no nodules. Patient was started on levothyroxine therapy due to enlarged thyroid. After two years of follow-up, serial ultrasounds have not shown any change in thyroid or cyst size. He continues to be chemically euthyroid and repeat thyroid antibodies continue to be negative.
Patient was a 13 year old male who presented to the emergency department with complaints of fever and neck stiffness. Patient had been otherwise healthy and without symptoms or family history of thyroid disease. On exam, the patient had left tonsillar enlargement with left sided cervical lymphadenopathy, and no palpable goiter or thyroid nodules. On computerized tomographic (CT) imaging of the neck done for suspicion of retropharyngeal abscess, discovered a prominent thyroid with multiple cysts bilaterally. This patient was lost to follow up after the initial evaluation. Ultrasound findings are shown at the top of the Figure.
PATIENT 6
Patient was a 7 year 10 month old female referred to
116 La State Med Soc VOL 170 JULY/AUG 2018
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