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Case report
Case of cholestatic jaundice associated with papillary carcinoma of thyroid: a multidisciplinary challenge
  1. Sanchit Sharma1,
  2. Anoop Saraya1,
  3. Prasenjit Das2 and
  4. Deepak Gunjan1
  1. 1Gastroenterology and Human Nutrition Unit, AIIMS, New Delhi, India
  2. 2Pathology, AIIMS, New Delhi, India
  1. Correspondence to Dr Deepak Gunjan; drdg_01{at}rediffmail.com

Abstract

The report describes a patient with cholestatic jaundice who had incidentally detected parathyroid hormone-independent hypercalcaemia. The differential diagnosis for this presentation includes systemic granulomatous and infiltrative disorders, drug-induced liver injury and malignancy. As the initial investigations were non-contributory towards the aetiology, she was given steroids and later plasma exchange for symptomatic treatment. The differentials were revised again in view of no clinical and biochemical response. A repeat fine-needle aspiration cytology of the thyroid nodule (seen on positron emission tomography/CT) revealed papillary carcinoma of the thyroid. The patient underwent total thyroidectomy. There was a complete normalisation of liver function tests and serum calcium, and resolution of pruritus 3 months post surgery. She was retrospectively diagnosed as a case of papillary carcinoma of the thyroid with paraneoplastic manifestations—hypercalcaemia and cholestatic jaundice—which got resolved with treatment of the primary tumour.

  • gastrointestinal system
  • malignant disease and immunosuppression
  • thyroid disease

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Footnotes

  • Contributors SS: Resident, involved in the management of the case and drafting of the manuscript. AS: Faculty, involved in the management of the case and critical revision of the manuscript. PD: Interpretation of biopsies and revision of the manuscript. DG: Overview of management of the case, and drafting and critical revision of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer-reviewed.