Abstract
A 56-year-old woman who had a past history of Sjögren's syndrome was referred to our hospital with an abnormal shadow on chest radiograph in a routine medical checkup. Computed tomography (CT) showed a nodular lesion, including calcification, located in the right thyroid lobe. Ultrasonography revealed that the nodular lesion was about 2.5 cm in diameter, including calcification and had an irregular shape. Fine needle cytology revealed papillary carcinoma. Serum concentration of anti-Tg-antibody, rheumatoid factor, γ-globulin, IgG, anti-nuclear-antibody, anti-SS-A-antibody, and anti-SS-B-antibody were all elevated. Operative procedures included total thyroidectomy and D2b lymph node dissection. Papillary carcinoma in the right thyroid lobe associated with chronic thyroiditis was conclusively diagnosed. One year after the operation, the dry eyes and dry mouth were remarkably improved. Three years after the operation, the high anti-Tg-antibody and anti-SS-B-antibody level dropped to the normal range. We suggested that the improvement of Sjögren's syndrome by total thyroidectomy was due to a common immunological imbalance between Sjögren's syndrome and chronic tyroiditis.
