Abstract
We present two cases of pulmonary MAC infection in women with Hürthle cell thyroid carcinoma. Both cases were asymptomatic octogenarian women with active Hürthle cell thyroid carcinoma and prolonged periods of hypothyroidism prior to diagnosis of pulmonary MAC. Mycobacterium avium complex has never been reported in association with any type of thyroid cancer, specifically Hürthle cell carcinoma. A review of the literature and possible associations between the two are discussed in this article.
Highlights
Hürthle cell thyroid carcinomas are a type of well-differentiated thyroid carcinoma and are either classified as a subset of follicular carcinoma or a separate category of well-differentiated thyroid cancer [1]
We present two cases of pulmonary mycobacterium avium complex (MAC) infection in octogenarian women with active Hürthle cell thyroid carcinoma
Four different clinical syndromes of pulmonary MAC infection have been described. These include classic cavitary disease seen commonly in middle-aged smoking males [6]; nonclassic forms such as bronchiectasis and multiple nodules found in elderly women [6,8], MAC lung disease in cystic fibrosis patients [10], and a hypersensitivity pneumonitis associated with hot tub use [11]
Summary
Hürthle cell thyroid carcinomas are a type of well-differentiated thyroid carcinoma and are either classified as a subset of follicular carcinoma or a separate category of well-differentiated thyroid cancer [1]. Hürthle cell carcinomas usually produce thyroglobulin, but are often less iodine avid, and are more aggressive than the other types of well-differentiated thyroid carcinoma such as papillary or follicular [2,3]. Follow-up for Hürthle cell thyroid cancer is similar to papillary and follicular thyroid cancers, which entails anatomic imaging of the neck and chest. This is usually done with neck ultrasound and computed tomography (CT) scans of the chest and occasionally neck; and when indicated, TSH-stimulated I-131 whole body scan is performed. Despite its more aggressive course, there are no known associations between Hürthle cell thyroid cancer and immunocompromised states; there are no published reports of Hürthle cell thyroid carcinoma and pulmonary MAC infection. We present two cases of pulmonary MAC infection in octogenarian women with active Hürthle cell thyroid carcinoma
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