A Rare Case of Papillary Thyroid Carcinoma in Marine-Lehnhart Syndrome—Indication for Biopsy of Hot Thyroid Nodules?

An uncommon occurrence in which Graves disease (GD) coincides with autonomous functioning thyroid nodules (AFTNs) is termed Marine-Lehnhart syndrome (MLS). While hyperfunctioning nodules in MLS are commonly benign, there exists a rare potential for malignancy. A 41-year-old male patient was initially managed conservatively upon being diagnosed with MLS type 1. However, the emergence of obstructive symptoms prompted a thyroidectomy 4 years after initial presentation. Histological analysis revealed 2 cervical lymph node metastases and papillary thyroid cancer (PTC) within the AFTN.