A woman with cancer went undiagnosed for months because she experienced extremely unusual symptoms of the disease.
The 54-year-old had been suffering from a chronic cough for six months before she was finally diagnosed with a tumor on her thyroid.
The Malaysian woman had dismissed her symptom as something much more innocent, but sought help when she started coughing up blood.
She underwent numerous tests before doctors discovered she had an enlarged thyroid gland, prompting them to take a biopsy of the gland and ultimately diagnosing it with papillary thyroid cancer.
The above image is from the woman’s CT scan, which shows the swollen left thyroid gland slightly compressing her trachea
The above image shows the compression area on the woman’s trachea. It comes from a bronchoscopy, a procedure that looks at airways with a small camera on the end of a flexible tube.
The woman, who also had diabetes and high blood pressure, was not identified in the review of her case, which was published in the American Journal of Case Reports.
Doctors wrote that hemoptysis, the coughing up of blood, is an “uncommon presentation of papillary thyroid cancer in primary care and requires a high index of suspicion and comprehensive assessment to reach a final diagnosis.”
It is common in patients with lung cancer, bronchitis and pneumonia.
The woman had no fever, shortness of breath or other complaints. She had no history of radiation exposure – a risk factor for thyroid cancer – and had no family members with thyroid cancer.
Doctors also found no neck swelling or lumps. Upon examining her, doctors discovered that she had a normally functioning thyroid gland. She also had no breathing problems.
Additional testing revealed nothing significant. There were no signs of infections and all her blood tests showed normal results. Her thyroid function test, a series of tests to check the function of the thyroid gland, was normal.
Ultimately, doctors performed a CT scan of the area between her abdomen and the base of the neck to investigate the cause of the bloody cough.
The images showed that the left side of her thyroid was enlarged and contained a nodule (or nodule) and calcifications, which are small spots of calcium within the nodule, a prominent feature of cancer.
It was also observed that her thyroid gland was partially compressing her trachea, or trachea.
This prompted the doctors to perform an ultrasound of the thyroid gland, which revealed more nodules, prompting her medical team to perform a biopsy of the nodules.
When additional tests revealed that the lumps were cancerous, the woman had her entire thyroid gland removed due to the large size of the tumor and suspicion that the cancer had spread to locally surrounding areas.
After surgery, the patient received two cycles of radioactive iodine therapy, which is used to destroy any thyroid tissue left after surgery. RAI therapy is taken via an oral capsule and in most cases patients do not need to be hospitalized.
The thyroid is a gland in the front of the neck that is responsible for making hormones that control how the body uses energy
Thyroid cancer is more common in women and symptoms include difficulty swallowing and a felt lump in the neck
Some studies have found that thyroid cancer is ‘one of the rare causes’ of a bloody cough and doctors in this case think it was caused by the thyroid gland invading the trachea.
The thyroid is a gland in the front of the neck that is responsible for making hormones that control how the body uses energy. Hormones produced by the thyroid gland affect almost every organ in the body and control many of the body’s most important functions.
Thyroid cancer may not cause any symptoms at first, but as the cancer grows it can cause swelling of the neck, voice changes, difficulty swallowing, a lump that can be felt through the skin of the neck, and pain in the neck and throat.
There are several types of thyroid cancer, of which papillary thyroid cancer is the most common. It can occur at any age, but is most often seen in people between the ages of 30 and 50.
Women are more likely than men to develop thyroid cancer, as experts believe this may be related to the hormone estrogen, which is present in higher levels in women. Radiation exposure and inherited genetic disorders are also risk factors.
Treatment for papillary thyroid cancer includes removal of part or all of the thyroid gland, radioactive iodine therapy, hormone therapy, and external beam radiation therapy.
The American Cancer Society estimates that there will be approximately 43,720 new cases of cancer and approximately 2,120 deaths this year.
The five-year survival rate for papillary thyroid cancer that has spread beyond the thyroid gland to nearby structures is 99 percent, but varies depending on a patient’s age and general health.