Clinical presentation: A 40-year-old woman was referred for evaluation of recurrent hyperthyroidism and severe thyroid associated ophthalmopathy. She has been treated for Graves' disease for more than 3 years which has relapsed twice.

Palpation: no abnormality.

Laboratory tests: TSH 2.81 mIU/L, FT4 12.9 pM/L. TSAb was 9.0 U/L two months ago at the time of the last relapse.

Ultrasonography. The thyroid was partly hypoechogenic partly echonormal and has multiple discrete areas of various echogenicity and size. There were no nodules of oncological significance.

Considering the severe TAO and the recurrent hyperthyroidism a total thyroidectomy was performed. Histopathology: Diffuse goiter corresponding to Graves' disease.

 

 

 

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