Table 4 Similar presentations of papillary thyroid carcinoma reported in the literature review

Kwon S.H. et al., 2023 [39]

67/F

CC: Drowsiness, fever. HX: Type 2 DM, HTN, total thyroidectomy 4 years prior. PH/E: Fever, tachycardia. Lab: Severe thyrotoxicosis (TSH < 0.008, T4 > 12.0 ng/dL). Imaging: PET/CT with pelvic bone metastasis.

DX: Thyroid storm due to metastatic PTC. TX: Antithyroid regimen, beta-blockers, corticosteroids. Prog: Died on day 6 after hospitalization.

Arosemena et al., 2022 [56]

32/M

CC: Weight loss (20 lbs). HX: No known past medical history, hyperthyroidism with elevated T4 and T3. PH/E: Non-enlarged thyroid, no orbitopathy. Lab: TSH < 0.01, TSI 8, Tg 53 ng/mL. Imaging: Hypervascular nodule, thyroid uptake scan 70.2%.

DX: Graves' disease and PTC. TX: Thyroidectomy, RAI therapy, BRAF V600E positive. Prog: Stable, awaiting 6-month follow-up.

Hu et al., 2020 [57]

Case 1: 55/F

Case 2: 43/F

Case 1: CC: Cervical mass, tremors, hyperactive mood. HX: GD, right AFTN. PH/E: Palpable nodule. Lab: TSH < 0.004, T4 227.6, TRAb 14.42. Imaging: 4 cm adenoma with PTC.

Case 2: CC: Cervical mass. HX: HD. PH/E: Right lobe nodule. Lab: TSH < 0.01, T4 250.7. Imaging: Right hyperfunctioning nodule (0.4 cm).

Case 1: DX: Marine-Lenhart syndrome with bilateral PTC. TX: Total thyroidectomy. Prog: Stable.

Case 2: DX: Toxic nodular goiter with PTC. TX: Right hemithyroidectomy. Prog: Stable.

Krishnaja et al., 2019[58]

63/F

CC: Headache, soft-tissue swelling on scalp, palpitations, anxiety, weight loss. HX: Post-thyroidectomy for PTC, defaulted treatment. PH/E: High pulse (112 bpm), tremors, staring look. Lab: Tg > 481 ng/mL, TSH 0.03 mIU/L. Imaging: I-131 scan showing lung, skeletal, and lymph node metastasis.

DX: Metastatic PTC with thyrotoxicosis. TX: HDRAI, thyroxine suppression therapy. Prog: Improvement of thyrotoxicosis but persistent metastases.

Pinto et al., 2019 [59]

71/F

CC: Back pain, leg weakness. HX: HTN, A-Fib, CHF, CKD. PH/E: Sacral mass on MRI. Lab: TSH <0.01, T4 > 8.0 ng/dL, TG 79,090 ng/mL. Imaging: 12.4 cm sacral mass with metastasis to S1-S5.

DX: Thyroid storm with coma due to metastatic PTC and GD. TX: Antithyroid drugs, steroids, therapeutic plasma exchange, thyroidectomy. Prog: Died despite resolution of thyroid storm.

Sacks et al., 2013 [32]

37/M

CC: Painless lump in neck. HX: Multifocal, bilateral PTC with lymphovascular invasion and extra nodal extension. PH/E: Palpable lymphadenopathy. Lab: Tg > 3000 ng/mL. Imaging: Neck and chest CT, ultrasound showing diffuse malignant lymphadenopathy.

DX: Aggressive metastatic PTC. TX: Thyroidectomy, lymph node dissection, RAI therapy, EBRT. Prog: Stable disease with decreased lung nodules, but persistent metastases.