ESPE Abstracts (2018) 89 P-P3-378

Clinical Case (Children's Endocrinology)

Ieva Strauhmane, Gunda Zvigule - Neidere, Ieva Kravale, Iveta dzivite-Krisane & Inita Kaze


Children Hospital, Riga, Latvia


Clinical case: 05.11.2017 – On the visit of endocrinologist came 16-year-old girl arrives on an outpatient visit to evaluate and treat post-operative hypothyroidism. The patient has complaints about periodic pain in the neck of the scar area. From an anamnesis it is known that in December 2016, a patient was diagnosed thyroid papillary carcinoma at stage T1b. 07.12.2016. extirpation of total right thyroid lobe on is complete, after receiving a histological answer on March 27, 2017 - total extirpation of the left thyroid lobe. The girl is taking 25 μg levothyroxine once a day in the morning. When evaluating laboratory performance, hypothyroidism is uncompensated. It is recommended to increase the dose of levothyroxine to 75 μg once daily and repeat the US thyroid gland one month later.

Disease history: After birth – 2000 year, the girl was found a congenital abnormal formation in the left arm of the right muscle. A partial resection of the tumor with biopsy was performed. Pathogistological response - aggressive fibromatosis, extra-abdominal desmoid tumor, infantile variant. Further treatment was discussed at the congress of hematologists and oncologists, which decided to start chemotherapy following the COS protocol. 2001 year At seven months of age, the girl was subjected to a partial desmotomy tumor excision. Histological response is identical to the previous one. It was decided to make radical surgical treatment. Year 2011 At the age of ten, a girl was found formation in the left gluteal region. Diagnosis: Liposus regio glutei sinistra. 2016 year. The patient has a colon prolapse of 15 years of age. Surgical treatment was performed and scheduled colonoscopy was prescribed. Conclusion: suspected colon polyposis. Histological examination of biopsy material: fragments of the large intestine mucosa with crypt tubular structure, mild dysplasia of decay epithelium, polyphony restructuring. Conclusion: Colon tubular adenoma structures. September 27, 2016 The patient is hospitalized in a regional hospital with complaints of headache that lasts for the second day. There have been dizziness, chills, subfebrile temperature, decreased appetite. Thyroid ultrasonography was performed, in which abnormal formation in the right lobe was detected centrally. 07.12.2016. Total extirpation of the right lobe of the thyroid gland of the girl, audit of the left lobe. Thyroid papillary carcinoma (T1b) has been detected in a biopsy histological examination. Basic diagnosis: family adenomatous polyposis - Gardner syndrome; Thyroid papillary carcinoma, T1b, i.e., total thyroidectomy, post-operative hypothyroidism, compensated. Complications: secondary hyperparathyroidism; iron deficiency anemia.

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