Case 129 -- Multiple Myxomas and Thyroid Cancer

Contributed by Jiangzhou Wang, MD, PhD. and Mohamed A. Virji, MD, PhD.
Published on line in January 1998


CLINICAL HISTORY:

A 36-year-old white female was admitted for 131I therapy for recurrent thyroid follicular carcinoma. The patient has recently reported that she has swelling of her palms and fingers, her palms feel continuously sweaty, and she has cold feet.

PAST MEDICAL HISTORY

  1. The patient had a large angioma removed from the left lower abdomen at birth.
  2. The patient had a large armpit "fibroid mucous" tumor removed at age 11.
  3. The patient had multiple fibromas and myxomas revoved from the face and neck area.
  4. The patient had myxomas removed from her breasts and vulva.
  5. The patient had myxomas removed from left ventricle in 1991.
  6. The patient was noted to have Cushing's syndrome in 1991; suppression tests failed to suppress her urinary free cortisol but her ACTH levels were suppressed.
  7. The patient had a total thyroidectomy followed radioactive iodine-131 treatment in 1992.
  8. The patient had myxomas removed from left atrium in 1995.
  9. The patient is noted to have possible lung tumor and polycystic ovarian tumor in 1996.
FAMILY HISTORY

Patient's father died at 73 with coronary artery disease. Her mother died at age of 62 with an aneurysm, she appeared cushingnoid and had nevi of her lips and eyelids. Her two brothers died of "heart disease"; one of them had a pituitary tumor. The patient has a sister who is alive and has had problems with cardiac arrythmias. The patient has two children. Her son has nevi and a testicular seminoma which was removed , and has had a small thyroid nodule detected recently. Her daughter has hirsutism, and the results of her ACTH stimulation test are consistent with congenital adrenal hyperplasia.

SOCIAL HISTORY

The patient has smoked one pack of cigarettes per day for approximately 20 years.


PHYSICAL EXAMINATION & LABORATORY DATA

FINAL DIAGNOSIS


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