PMC5287984_01
PMC5287984_02
X-ray of skull (A) and left femur (B); X-ray of skull and left femur showed no osteolytic lesions.
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F1
Her X-ray examination on chest, thoracic and lumbar vertebrae, left femur and skull were all normal (Fig. 1).
Color ultrasonography examination. (A) Thyroid color ultrasonography showed multiple nodules with high echo (a 21 mm x 11 mm high echo thyroid nodule was represented by a red arrow). (B) Right kidney stone (a single hyperechoic nodule of 11 mm x 8 mm with acoustic shadow, represented by a red arrow), right kidney cysts (represented by yellow arrow); (C) hysteromyoma (red arrow).
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F2
Color ultrasonography showed thyroid multiple nodules with high echo patterns (right lobe: 20 mm x 13 mm; left lobe: 10 mm x 8 mm; isthmus: 7 mm x 7 mm) and no malignant lesions were found, hysteromyoma, right kidney stone (a single hyperechoic nodule of 11 mm x 8 mm with acoustic shadow), double kidney cysts (left kidney cysts was no shown), and normal breast and heart structures (Fig. 2).
Thyroid ultrasound image: Sulfur hexafluoride contrast-enhanced ultrasound revealed nodular goitre with no malignant changes. Two thyroid nodules (above: 21 mm x 11 mm; below: 14 mm x 21 mm) were represented by red arrows.
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F3
To further investigate the existence of any malignant tumor, sulfur hexafluoride contrast-enhanced ultrasound was performed and revealed a nodular goitre (Fig. 3).
PMC5287984_03
Serum calcium and phosphate levels after treatment of hyperthyroidism and hypercalcemic crisis. Area confined by 2 short dash lines represented the normal range of serum calcium (between 2.08 and 2.80 mmol/L) and area confined by 2 long dash lines represented the normal range of serum phosphate (between 0.90 and 1.34 mmol/L). Ca = calcium, P = phosphate.
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F4
Her serum calcium level quickly returned to normal after 24 hours of treatment, although it fluctuated at days 4 and 5 (Fig. 4). Eight months later, her calcium (2.47 mmol/L) and phosphorus (1.10 mmol/L), as well as her thyroid function remained normal (Fig. 4).