{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T01:56:07Z","timestamp":1788314167373,"version":"build-2803163510"},"reference-count":0,"publisher":"Journal of the ASEAN Federation of Endocrine Societies (JAFES)","license":[{"start":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T00:00:00Z","timestamp":1722384000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J ASEAN Fed Endocr Soc"],"abstract":"<jats:p>We report a case of an uncommonly aggressive presentation of the rare entity of synchronous papillary (PTC) and follicular thyroid carcinomas (FTC) in a 67-year-old woman initially presenting with thyrotoxicosis from Graves\u2019 disease. She was found to have two thyroid nodules with extensive intra-cardiac tumour thrombus, symptomatic left pelvis bony metastasis with pathological fracture, pulmonary metastases and mediastinal lymph node metastases. Further investigations suggested a diagnosis of synchronous papillary and metastatic follicular thyroid cancer. Treatment with radical surgery followed by adjuvant therapeutic radioiodine ablation was proposed, but the patient declined all forms of cancer-specific therapy and was elected solely for a palliative approach to treatment. We discuss the diagnostic considerations in arriving at the diagnosis of synchronous thyroid malignancy \u2013 in this case the clear features of PTC and the strong probability of FTC due to invasiveness and metastatic follicular lesions. This case underscores potential limitations of the ACR TI-RADS system, notably with certain ultrasonographic features suggesting malignancy that might not be adequately captured. Notably, the aggressive presentation of DTC in this case may be contributed by the concurrent presence of Graves\u2019 Disease, suggesting heightened vigilance when assessing potential thyroid malignancies in such patients.<\/jats:p>","DOI":"10.15605\/jafes.039.02.08","type":"journal-article","created":{"date-parts":[[2024,8,20]],"date-time":"2024-08-20T06:00:32Z","timestamp":1724133632000},"source":"Crossref","is-referenced-by-count":1,"title":["Aggressive Synchronous Papillary and Likely Follicular Thyroid Carcinomas in a Patient with Graves\u2019 Disease"],"prefix":"10.15605","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8795-7491","authenticated-orcid":false,"given":"Gerald Gui Ren","family":"Sng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5451-788X","authenticated-orcid":false,"given":"Sarah Ying Tse","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9728-3489","authenticated-orcid":false,"given":"Edwin Jun Chen","family":"Chew","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sangeeta","family":"Mantoo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2232-5298","authenticated-orcid":false,"given":"Chiaw Ling","family":"Chng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"6244","published-online":{"date-parts":[[2024,7,31]]},"container-title":["Journal of the ASEAN Federation of Endocrine Societies"],"original-title":[],"link":[{"URL":"https:\/\/asean-endocrinejournal.org\/index.php\/JAFES\/article\/download\/2925\/4151","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/asean-endocrinejournal.org\/index.php\/JAFES\/article\/download\/2925\/4151","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,20]],"date-time":"2024-08-20T06:01:55Z","timestamp":1724133715000},"score":1,"resource":{"primary":{"URL":"https:\/\/asean-endocrinejournal.org\/index.php\/JAFES\/article\/view\/2925"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,31]]},"references-count":0,"URL":"https:\/\/doi.org\/10.15605\/jafes.039.02.08","relation":{},"ISSN":["2308-118X","0857-1074"],"issn-type":[{"value":"2308-118X","type":"electronic"},{"value":"0857-1074","type":"print"}],"subject":[],"published":{"date-parts":[[2024,7,31]]}}}