Coexistencia de tres diferentes patologias tiroideas / Coexistence of three different thyroid diseases

The case of a 53 year old woman, coming from a goitrogenous area, who developed a clinical picture of subacute thyroiditis is reported. The 99m Technetium scan was normal and a needle aspiration cytology showed multinucleated giant cells; the patient underwent total thyroidectomy. The histological examination revealed the association of multinodular goiter, papillary invasive multicentric carcinoma and granulomatous thyroiditis. The coexistence of these 3 different diseases in a single patient and the role of cancer as a possible etiologic factor of granulomatous changes of the thyroid gland are discussed.