P127 - ULCERATIVE COLITIS AND PAPILLARY THYROID CARCINOMA – IS THERE AN ASSOCIATION?
(Room Poster Hall)
19 Jan 18
5:30 PM
-
7:00 PM
Tracks:
Clinical and Research Challenges
A 26-year-old male with ulcerative pancolitis diagnosed 11 years before, with episodes of severe colitis and steroid-dependent disease, was initially managed with azathioprine and infliximab, latter switched to adalimumab due to an infusion reaction. For the past 7 years he had been under adalimumab 40mg every 2 weeks and messalazine 1,5g/day, with complete remission. In 2015 the patient perceived an asymptomatic cervical swelling. An ultrasound scan revealed a heterogeneous nodule of the right thyroid lobe with lymphadenopathies. Fine-needle aspiration cytology confirmed papillary thyroid carcinoma. Adalimumab was suspended upon the carcinoma diagnosis, however 1 month latter, under messalazine, a moderate flare occurred. After multidisciplinary discussion and the patient’s refusal to undergo a proctocolectomy, adalimumab was resumed. He underwent total thyroidectomy with radical lymph node dissection (pT3N1bMx) followed by radioactive iodine therapy. Currently, 24 months after radioactive iodine therapy, the cancer and the ulcerative colitis are in complete remission. The association between inflammatory bowel disease and thyroid carcinoma has been rarely described. However, the overlapping immunologic pathways or the known increase in malignant neoplasms associated to immunosuppressive therapy, may connect these two diseases. If, on the contrary, they are unrelated, this case may illustrate how specific therapy for both conditions may be safely used.