Thyrotoxic Crisis and Electrolyte Disturbances in a Patient with Functioning Metastatic Carcinoma of the Thyroid: Chromatographic and Electrophoretic Studies
A patient with thyrotoxicosis secondary to hyperfunctioning distant metastases from carcinoma of the thyroid is presented; the patient died due to thyroid crisis. No functioning thyroid tissue could be identified in the neck, whereas the metastases avidly concentrated radioactive iodine, secreting abnormally large amounts of thyroxine and/or triiodothyronine, as demonstrated by chromatographic and electrophoretic studies of the serum. Electrolyte changes characterized by hypokalemic alkalosis, hypercalcemia and hypophosphatemia were present, leading to a persistent vasopressin-resistant polyuria and hyposthenuria. Thyrotoxic crisis arising from metastatic cancer is discussed.