Adenomatous Goiter with Hyperthyroidism in 12 Years Old Female

Background: Hyperthyroidism is a condition in which the thyroid overproduces hormones and associated with a complex physiological and biochemical condition. Hyperthyroidism in children is often caused by toxic thyroid nodule and toxic adenoma, and very rarely caused by adenomatous goiter with incidence only 1, 5 %. Case Presentation Summary: We report a 12 years old female with adenomatous goiter hyperthyroidism. The patient�s complained of feeling exhausted and there were weight loss in last 3 months. From physical examination body weight is 35 kg (percentile 10-25 CDC 2000), body height 144cm (percentile 10-25 CDC 2000), head circumference 52, 5cm (Mean 50 % nellhaus). There is a solid mass in the neck, fixed, no redness, tenderness nor signs of inflammation. From laboratory examination revealed thyroid hormone increased with FT4 60, 3 ng/dl (0.93-1.70 ng/dl) while TSH decreased in 0, 05 IU/ml (0.27-4.20IU/ml), TRAb (-). USG examination showed solid mass with cystic degeneration, CT-scan of head and midface showed cystic solid mass with central necrotic calcification. Fine needle aspiration biopsy showed cytomorphology according to follicular neoplasms with cystic degeneration and biopsy of the nodule showed adenomatous goiter. Patient underwent for total thyroidectomy and after one week post operation the thyroid hormone decline and patient planned for lifelong treatment of thyroid hormone replacement. Summary: Hyperthyroid caused by adenomatous goiter is a very rare case. The manifestation including symptoms and sign of hyperthyroid with biopsy showed adenomatous goiter.