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presented at: B ES 2 0 1 6 Clinical presentation A 32 year old lady presented with a history of weight loss, sweating, tremor and anxiety and biochemical hyperthyroidism; fT4 41pmols/l (9.00-25.00pmols/l) TSH <0.05miu/l (0.30-5.00miu/l); strongly positive TPO antibodies (1600IU/ml.). She was toxic clinically, had subtle left sided proptosis and a palpable left sided thyroid nodule. She was started on Carbimazole 20mg and the initial differential diagnosis was between Grave’s disease and a toxic thyroid nodule.

Papillary thyroid cancer within an auto-immune goitre: two birds with one stone