Thyroid Sporadic Goiter with Adult Heterotopic Bone Formation

Table 1

Clinical features of the 5 patients with adult bone metaplasia.

Case; number

Age (years)

Gender

Euthyroid

Punction

Presurgical diagnosis

Cardiovascular disease

Dyslipidemia

Diabetes

Osteoarticular disease

Impaired renal function

BMI

Type of thyroid surgery

Morphological diagnosis

Postsurgical hypocalcemia

1

51

W

No

No

Toxic goiter

AHT, tachycardia cardiomegaly

NA

No

Odontoid chondrocalcinosis, C4–C7 arthrosis

No

31.3

Right and left thyroid lobectomies

Sporadic goiter

Yes

2

33

W

Yes

No

Multinodular goiter (trachea deviation)

No

NA

No

No

Yes

32

Total thyroidectomy

Sporadic goiter

No

3

63

W

Yes

No

Multinodular goiter

AHT, mitral stenosis

Yes

Yes

No

Yes

22.5

Total thyroidectomy

Sporadic goiter

Yes

4

83

W

No

No

Left cystic nodule (trachea deviation)

AHT

NA

No

Osteoporosis

Yes

26.4

Left thyroid lobectomy

Goiter with adenoma-like nodule

No

5

71

W

Yes

Yes

Compressive cyst

AHT

Yes

No

Arthrosis, serum vitamin D OH 25D1 D3 insufficiency, and hyperuricemia

No

41.9

Right thyroidectomy

Follicular adenoma, cystic change

Yes

BMI: body mass index, NA: nonavailable, W: woman, and AHT: arterial hypertension.
The punction was performed for evacuating the cyst (65 mL); no cytological analysis was performed (Case 5).
Hyperthyroidism was diagnosed in Cases 1 and 4 and treated by carbimazole and thyroxin for 1.5 years in Case 1 and by carbimazole only in Case 4 (for 15 days due to temporary drug unavailability).
Decreased serum creatinine was diagnosed in Case 2, hypocalcemia and hypoalbuminemia were diagnosed in Case 3, and renal failure was diagnosed in Case 4. The type of dyslipidemia was not available in Case 3 and consisted in hypercholesterolemia and hyper-LDL-emia in Case 5. Cases 4 and 5 showed fluctuant hyperglycemia. Case 3 diabetes was type II.
Case 4 showed a history of sigmoidectomy for diverticulosis (date NA), gastric resection for gastrointestinal stromal tumor (date NA), and breast cancer (treated by surgery, radiotherapy, and hormonotherapy). Case 5 showed a history of appendectomy and skin papillomas. Case 3 showed hypoacusia (prosthesis).
There was no alcohol abuse in any of the cases; smoking habits (10 PA) were noted in Case 2. A treatment with propranolol was known for Case 1 and with atorvastatin, metformin, Lectil, beta-histidine chlorhydrate, metformin, glimepiride, hydroxyzine (allergy to penicillin and cetirizine), alendronic acid, spironolactone, atenolol, and zolpidem for Case 4. Allergy to fish and amoxicillin was known in Case 5, to penicillin and cetirizine in Case 3, and to penicillin and aspirin in Case 4.