Graves' Hyperthyroidism with Incidental Ossified Nodular Lesion

Thyroid nodules are not uncommon, and they may undergo a wide range of degenerative changes such as infarction, hemorrhage or fibrosis. Sometimes, the calcified deposition may be detected in a nodular goiter. However, ossification in thyroid nodules is extremely rare. Moreover, the risk for malignancy of thyroid nodules in patients with Graves' disease is more than in those with euthyroid nodular goiters. Here, we report a 23-year-old woman with Graves' disease who was found to have a solitary nodule on ultrasonography during the course of antithyroid drug treatment. Pathologic report showed a hyalinized nodule with ossification. We believe that this is the first reported case of a hyalinized thyroid nodule with ossification in Graves' disease in the English literature. The clinical importance of such histologic change needs more investigation.