Abdelaal, Abdelrahman1; Alhassan, Mohammed1; Saafan, Tamer1
1 General Surgery Department , Hamad General Hospital , Hamad Medical Corporation , Doha, Qatar
Background: Most common primary thyroid cancers are papillary carcinoma and follicular carcinoma, 85 % and 12 %, respectively (1). Simultaneous papillary microcarcinoma and follicular thyroid cancers in the same thyroid lobe is very rare and was described only in one published study (2).
Methods: 34 year old Egyptian female patient presented with one year history of left neck swelling, had no change of voice or compression symptoms and no family history of thyroid disease. On physical exam, patient was euthyroid and there was 4×3 cm mobile thyroid mass at the left side. Ultrasound neck showed a 50×25 mm iso to slightly hyperechoic predominantly solid nodule in the left thyroid lobe with small thin peripheral halo, peripheral and central vascularity and coarse calcifications, and 4×3 mm hypoechoic nodule in the right thyroid lobe. FNA from the left thyroid nodule showed a follicular lesion of undetermined significance. Left hemithyroidectomy was done.
Results: The histopathological analysis of the left thyroid lobe showed follicular thyroid carcinoma 5×4 cm in size, pT3 N0, and 1.3 cm papillary thyroid carcinoma, pT1bN0. Completion thyroidectomy was done and right thyroid lobe pathology showed chronic lymphocytic thyroiditis, no malignancy. Patient was scheduled for radioactive iodine ablation.
Conclusion: We described a young age female with mixed follicular thyroid cancer and classical papillary carcinoma in the same thyroid lobe which is very unique and has not been described before in the published literature.
- Haugen BR. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: What is new and what has changed? Cancer. 2017 Feb 1;123(3):372-381. doi: 10.1002/cncr.30360. Epub 2016 Oct 14. PubMed PMID: 27741354.
- Cupisti K, Raffel A, Ramp U, Wolf A, Donner A, Krausch M, Eisenberger CF, Knoefel WT: Synchronous occurrence of a follicular, papillary and medullary thyroid carcinoma in a recurrent goiter. Endocr J 2005; 52: 281–285.