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Case Reports
. 2024 Aug 8:12:1388437.
doi: 10.3389/fped.2024.1388437. eCollection 2024.

Case Report: Plummer's adenoma in Prader-Willi syndrome

Domenico Corica #  1 , Fabio Toscano #  1 , Mariacarla Moleti  2 , Giorgia Pepe  1 , Alfredo Campenni  3 , Guido Fadda  4 , Gianlorenzo Dionigi  5 , Carmelo Romeo  6 , Tommaso Aversa  1 , Malgorzata Wasniewska #  1
Affiliations
Case Reports

Case Report: Plummer's adenoma in Prader-Willi syndrome

Domenico Corica et al. Front Pediatr. .

Abstract

Thyroid nodules in children are less common than in adults but they are approximately two- to three-fold more likely to be malignant in children. Among thyroid nodular diseases, Plummer's adenoma occurs very rarely in pediatrics, and currently, there is no literature providing evidence of this diagnosis in patients with Prader-Willi syndrome (PWS). We report the case of a 9-year-old Caucasian boy affected by PWS presenting with a rapidly growing palpable mass in the thyroid lodge associated with subclinical hyperthyroidism. Laboratory and other examinations (thyroid ultrasound, fine-needle aspiration of the nodule, and scintigraphy) were strongly suggestive for Plummer's adenoma; therefore, the patient underwent left hemithyroidectomy surgery, and anatomo-pathological examination confirmed the diagnosis. Our case describes the first evidence of an isolated follicular adenoma in children with PWS. Surgery is the only therapeutic option in younger children. Further evidence is needed to assess the possible correlation between these two conditions and the existence of potential risk factors.

Keywords: GH therapy; Plummer’s adenoma; children; subclinical hyperthyroidism; thyroid nodule.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The authors declared that they were an editorial board member of Frontiers at the time of submission. This had no impact on the peer review process and final decision.

Figures

Figure 1
Figure 1
The first thyroid ultrasound examination showing a solitary thyroid nodule with an LD of 17 mm in the left lobe.
Figure 2
Figure 2
Thyroid scintigraphy: a scintigraphic exam documenting a hyperfunctioning nodule, as shown by the focal iodine-131 concentration on the nodule with suppression of the surrounding thyroid gland tissue.
Figure 3
Figure 3
Diagnostic and therapeutic timeline. T0, the patient came to our attention with a palpable thyroid mass with an LD of 17 mm at the US exam, within normal thyroid function. T1, A FNAB was conducted due to the ultrasound dimensions of the nodule; malign causes were excluded. T2, after 6 months, the nodule grew up to 22 mm in LD, with evidence of some risk factors at the US exam, and TSH suppression was documented; a second FNAB confirmed a non-malignant lesion (TIR2) and the thyroid scintigraphy documented a focal iodine-132 concentration on the nodule with suppression of the surrounding gland tissue. T3, the patient underwent hemithyroidectomy surgery. T4, the histological examination confirmed the diagnosis of PA. Lab, laboratory exams; US, ultrasound; FNAB, fine-needle aspiration biopsy; PA, Plummer's adenoma; TSH, thyroid-stimulating hormone.
See this image and copyright information in PMC

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