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February 22, 2026The Nishinihon Journal of Dermatology0 citationsOpen Access

A Case of Pretibial Myxedema Leading to the Diagnosis of Graves' Disease and Papillary Thyroid Carcinoma

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THTakafumi HISAMOTOShimonoseki City HospitalHUHiroshi UchidaShimonoseki City Hospital

Key Points

  • To highlight how pretibial myxedema can lead to the diagnosis of Graves' disease and papillary thyroid carcinoma.
  • Conducted histopathological examination for diagnosis of pretibial myxedema
  • Performed blood tests to assess thyroid function including TSH, free T3, free T4 and antibodies
  • Utilized ultrasound for thyroid examination
  • Conducted fine-needle aspiration cytology for nodular lesions
  • Diagnosed pretibial myxedema through histological findings
  • Confirmed Graves' disease based on low TSH and elevated thyroid hormones
  • Identified papillary thyroid carcinoma via fine-needle aspiration results
  • Emphasized the rarity of pretibial myxedema but its clinical significance in thyroid diseases

Abstract

76 歳,女性。約 8 カ月前に両側下腿伸側に自覚症状を伴わない紅褐色局面が出現した。病理組織学的に膠原線維束間の開大とムチンの沈着があり,脛骨前粘液水腫と診断した。血液検査では TSH の低下,遊離 T3,遊離 T4,甲状腺刺激抗体,TSH レセプター抗体の上昇がみられ,Basedow 病と診断した。また甲状腺エコー検査では右葉に結節性病変を認め,甲状腺穿刺吸引細胞診の結果,甲状腺乳頭癌と診断した。脛骨前粘液水腫は稀ではあるが Basedow 病や甲状腺癌発見の契機となることがある。下腿伸側に局面,結節,圧痕を残さない浮腫を認めた際は本症を念頭に置いて皮膚生検を施行し,本症診断後は既往の有無にかかわらず甲状腺の精査を行うことが勧められる。

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Cite This Study

HISAMOTO et al. (2026) studied this question.

synapsesocial.com/papers/699a9cc6482488d673cd289ehttps://doi.org/10.2336/nishinihonhifu.88.33
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