J.Jpn. Surg. Soc.. 102(5): 417-420, 2001

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Case report

EXTREMELY HIGH LEVEL OF SERUM THYROGLOBULIN AFTER SURGERY IN A PATIENT WITH FOLLICULAR THYROID CARCINOMA. RECURRENCE, DISTANT METASTASIS, OR OTHER ETIOLOGY?

A 67-year-old female patient with a tumor of the thyroid underwent right lobectomy of the thyroid. The tumor was histologically diagnosed as a follicular carcinoma of the thyroid. Serum studies revealed very high (>8,000ng/ml) levels of thyroglobulin after surgery. We suspected distant metastases from follicular carcinoma or recurrence in the left lobe of the thyroid. She therefore underwent left lobectomy of the thyroid. No recurrence of follicular carcinoma was recognized in the resected thyroid tissue, but severe autoimmune thyroiditis was diagnosed histologically. Total-body ¹³¹I scintigraphy did not show abnormal distant uptake. Serum studies revealed very low levels of thyroglobulin (<2.0ng/ml) after the second surgery. We speculate that silent thyroiditis might have occurred after the first surgery, resulting in the high levels of serum thyroglobulin. Silent thyroiditis should be considered as a possible cause of high serum thyroglobulin levels.

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