8107 A Unique Convergence of Graves' Disease and Concurrent Lung Adenocarcinoma

Abstract Disclosure: P. Desai: None. S. yeasmin: None. D. Shah: None. Introduction: Graves' disease (GD) is a primary cause of hyperthyroidism in developed countries, predominantly affecting those aged 30-60 years. It is notably more prevalent in women, and its association with various solid tissue cancers is under study. However, the specific link between GD and lung adenocarcinoma remains inadequately explored. This vignette aims to shed light on a potential association between GD-induced hyperthyroidism and lung adenocarcinoma. Case Presentation: A 57-year-old woman presented with palpitations, chest pain, and near syncope. Notably, she had a remote history of breast carcinoma treated with lumpectomy and radiation. Initial evaluations indicated sinus tachycardia, elevated D-dimer, and transaminitis. Imaging excluded pulmonary embolism but highlighted irregularities in the lung and an anterior mediastinal mass suggesting thymic hyperplasia. Subsequent elevated free T4 (FT4) and suppressed thyroid-stimulating hormone (TSH) levels pointed towards GD, which was later confirmed by positive thyroid-stimulating immunoglobulin (TSI) and thyrotropin receptor antibody (TRAB) results. Despite methimazole therapy, persistent GD necessitated a total thyroidectomy. Further evaluations unveiled a newly diagnosed invasive adenocarcinoma of the lung, prompting a multidisciplinary approach involving surgical interventions and ongoing monitoring. Discussion: Research suggests that thyroid hormones influence oncogenic pathways, notably the phosphatidylinositol-3-kinase (PI3K) and ERK1/2 pathways. Elevated FT4 levels correlate with heightened susceptibility to solid cancers, including lung adenocarcinoma. Discrepancies in TSH and FT4 concentrations have been observed in lung cancer patients compared to healthy individuals. Understanding the nuanced relationship between hyperthyroidism, particularly GD, and malignancies like lung adenocarcinoma is vital. Delving deeper can pave the way for utilizing thyroid hormone levels as potential prognostic biomarkers. Presentation: 6/3/2024