Ferianto, Djonny
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Surgical Treatment Of Pendred Syndrome With Thyroid Nodule: A Case Report Ferianto, Djonny; Syamsu, Salman Ardi; Sapan, Vannes Caesar Palebangan; Indra; Sampepajung, Elridho; Pieter Jr, John
Nusantara Medical Science Journal Volume 9 Issue 2, July - December 2024
Publisher : Faculty of Medicine, Hasanuddin University.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20956/nmsj.vi.42770

Abstract

Introduction and importance: Pendred syndrome (PS) is a genetic disease inherited in an autosomal recessive pattern. In PS patients, the ability of thyroid gland to accumulate iodide in the follicle lumen is disrupted, causing insufficient thyroid hormone synthesis and goiter to occur as compensation. However, this symptom does not often appear, as goiter is only detected in 30–75% of PS patients. Presentation of case: A 33-year-old Buginese man complained of a painless mass in the neck. In the past 3 months, the mass has shown rapid growth, followed by symptoms of agitation, irritability, and hyperhidrosis. The patient was previously diagnosed with nodular goiter and was taking Levothyroxine. Furthermore, there was a history of the same disease in the patient’s grandmother and younger sibling. Physical examination showed grade III goiter (WHO criteria) with hard consistency and no palpable nodules. Laboratory tests showed routine blood tests, kidney and liver function in normal limits, 1.14 ng/dL FT4, free triiodothyronine level of 6.07 pg/dL, and 2,401 mIU/L TSH level. Chest X-ray results showed tracheal narrowing at the level of the superior thoracic aperture. Similarly, thyroid USG showed that the size of the right lobe was enlarged and anechoic. CT (Computerized Tomography) scan of the cervix showed diffuse enlargement in each lobe and the patient was diagnosed with PS. Right isthmolobectomy and thyroid biopsy were carried out and pathological anatomical examination results showed thyroid follicular nodular disease with cystic degeneration. After surgery, thyroxine hormone replacement therapy was continued. Discussion: Surgical intervention strategies may be employed to inhibit the advancement of disease and mitigate thyroid enlargement, consequently decreasing the likelihood of obstruction and malignancy. Conclusions: In cases of PS with large thyroid nodules pressing on the trachea, isthmolobectomy was carried out to obtain good results and no recurrence.
Mandibular Metastasis as a Rare Presentation of Follicular Variant Papillary Thyroid Carcinoma: A Case Series Hamdani, William; Patabang, Erwin A.; Haryasena , Haryasena; Ferianto, Djonny; Pieter Jr., John; Salman Ardi Syamsu
Nusantara Medical Science Journal Vol. 10 No. 2 (2025): Volume 10 Issue 2, July - December 2025
Publisher : Faculty of Medicine, Hasanuddin University.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20956/nmsj.v10i2.48914

Abstract

Introduction: Papillary thyroid carcinoma (PTC) is the most common endocrine malignancy. The follicular variant of papillary thyroid carcinoma (FV-PTC) represents a distinct histologic subtype that tends to spread hematogenously to distant organs, including bone. Mandibular metastasis from FV-PTC is exceedingly rare and may pose a diagnostic challenge, particularly when it precedes recognition of the primary thyroid lesion. Presentation of case:   We report two Asian female patients presenting with mandibular masses. The first patient had a history of total thyroidectomy for papillary thyroid carcinoma (follicular variant) ten years earlier. Imaging revealed an extensive osteolytic lesion of the right mandible. Histopathology of an incisional biopsy confirmed metastatic PTC, and the patient underwent right hemimandibulectomy with immediate reconstruction using a titanium plate. The second patient presented with a large, painful left mandibular mass without any history or clinical evidence of thyroid disease. Imaging showed a destructive lytic lesion of the left mandible, while neck ultrasonography revealed no thyroid enlargement. Biopsy suggested FV-PTC of thyroid origin. The patient underwent left hemimandibulectomy with titanium plate reconstruction. Final histopathology in both cases confirmed FV-PTC metastasis to the mandible. Conclusion: Mandibular metastasis from FV-PTC is a rare manifestation that may occur as late recurrence after thyroidectomy or as the first indication of an occult thyroid carcinoma. Comprehensive diagnostic workup and appropriate surgical reconstruction are crucial to achieve local disease control and preserve function. Clinicians should consider metastatic thyroid carcinoma in the differential diagnosis of lytic mandibular lesions, even in the absence of a palpable thyroid