Understanding the natural history of papillary thyroid cancer: Case series

Head & Neck ◽  
2019 ◽  
Vol 41 (12) ◽  
pp. 4164-4170
Author(s):  
Jonathan K. Lin ◽  
Lori C. Sakoda ◽  
Jeanne Darbinian ◽  
Whitney Chiao ◽  
Nathaniel Calixto ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Natural History ◽  
Papillary Thyroid Cancer ◽  
Case Series ◽  
Cancer Case ◽  
Papillary Thyroid ◽  
History Of

scholarly journals SUN-482 A Very Rare Case of Thyroid Cancer

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Vladimir Lokshin ◽  
Lina Soni ◽  
Milay Luis ◽  
Lisel Hope
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Papillary Thyroid Cancer ◽  
Hormone Replacement ◽  
Case Series ◽  
Needle Aspiration ◽  
Neck Mass ◽  
Completion Thyroidectomy ◽  
Papillary Thyroid ◽  
History Of

Abstract Background: Cribriform-Morular variant of Papillary Thyroid Cancer (PTC-CMV) is an exceedingly rare subtype of thyroid cancer that predominantly affects younger females. As the name implies, it is a papillary thyroid carcinoma with predominantly cribriform and morular pattern of carcinoma cells on cytopathology. While completion thyroidectomy is usually recommended for larger and higher-risk Papillary Thyroid Cancer (PTC), surveillance may be acceptable with PTC-CMV, which tends to be a less aggressive malignancy. Clinical Case: A 46-year-old Guyanese woman presented with a three week history of an enlarging right-sided neck mass associated with a globus sensation while swallowing food. She denied any history of radiation exposure. Her exam findings were positive for a tender, right-sided neck mass. CT neck without contrast revealed a 4.1 x 4.0 x 5.9cm heterogeneous mass within the right thyroid lobe causing mild tracheal deviation to the left. Ultrasound of thyroid gland showed a solid heterogeneous hypoechoic 4.22 x 2.39 x 2.46cm right lobe nodule with no microcalcifications, border irregularity or taller-than-wider morphology. Fine Needle Aspiration of the nodule came back as Atypia of Undetermined Significance. The patient then underwent a core needle biopsy. The resultant pathology was negative for thyroid carcinoma or medullary thyroid carcinoma but was suggestive of a bronchial cleft cyst versus bronchogenic cyst with atypical glandular proliferation. She subsequently underwent a right hemithyroidectomy which revealed a final pathological diagnosis of a 3.5cm PTC-CMV. Such pathology warranted the patient to undergo a colonoscopy which was negative for Familial Adenomatous Polyposis (FAP). Given her negative GI workup and non-contributory family history for colonic polyposis or carcinoma the decision was made to continue surveillance rather than performing completion thyroidectomy as the disease was presumed to be sporadic. Discussion: PTC-CMV accounts for 0.2% of all PTC. It is associated with FAP in more than 50% of cases but can also occur sporadically. This subtype of PTC generally follows a less aggressive course. Review of current literature revealed several case series of CMV-PTC patients. In the largest one, 32 cases were observed over a 19 year period and only two out of twelve patients with FAP-associated PTC-CMV initially treated with hemithyroidectomy developed recurrence to the contralateral lobe. Interestingly, none of the remaining patients with the sporadic type developed recurrence suggesting that completion thyroidectomy may not be mandatory in this group. It is, therefore, critical to identify these patients and screen them with a colonoscopy to avoid the potentially unnecessary resection of the contralateral lobe and the consequent need for thyroid hormone replacement.

Radio-guided surgery for persistent differentiated papillary thyroid cancer: case presentations and review of the literature

2006 ◽  
Vol 391 (3) ◽  
pp. 178-186 ◽  
Author(s):  
T. Negele ◽  
G. Meisetschläger ◽  
T. Brückner ◽  
K. Scheidhauer ◽  
M. Schwaiger ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Cancer ◽  
Cancer Case ◽  
Papillary Thyroid ◽  
Review Of The Literature ◽  
Guided Surgery ◽  
Case Presentations

scholarly journals Presentation of Pheochromocytoma, Papillary Thyroid Cancer and Hyperparathyroidism in Three Family Members

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A1004-A1004
Author(s):  
Damilola Ashorobi ◽  
Kaushik Mandal ◽  
Huijuan Liao ◽  
Salini Chellappan Kumar
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Cancer ◽  
Medullary Thyroid Cancer ◽  
Family Members ◽  
Papillary Thyroid ◽  
Urine Calcium ◽  
Medullary Thyroid ◽  
The Family ◽  
History Of ◽  
Men 2A

Abstract Introduction: Although rare, one of the most common inherited disorders is multiple endocrine neoplasia. It is an autosomal dominant disorder that predisposes individuals to certain endocrine abnormalities depending on which type. The type 2A is a combination of medullary thyroid cancer, hyperparathyroidism, and pheochromocytoma which have been explained to be due to a mutation in the RET proto-oncogene. This abstract present a case of a patient with hyperparathyroidism whom family members also have pheochromocytoma and papillary thyroid cancer. Case description: A 45 year-old Hispanic male came to the endocrinology clinic complaining of constipation and headache. He has a personal history of non-toxic multinodular goiter and underwent right sided thyroidectomy in 2015 with pathology report showing follicular adenoma. He is currently on thyroid replacement therapy. He is clinically and biochemically euthyroid with TSH of 2.29 IU/ml. Physical examination was unremarkable. His labs were pertinent for calcium 11.5mg/dl, parathyroid 245.7pg/ml, creatinine of 1.5mg/dl. Two years ago, parathyroid was 189.5pg/ml and calcium was 11mg/dl, 1.5 year ago parathyroid level was 235.5pg/ml, calcium was 11.4mg/dl, urine calcium 9.3mg/dl, 24hr urine calcium 286.4mg, calcitonin <2pg/ml, vitamin D 23ng/ml, 1,25 vitamin D 53ng/ml. In 2017, Sestambi scan showed equivocal focus of faint parathyroid activity in the region of the mid to lower left thyroid lobe versus faint residual thyroid activity and in 2019, scan showed no definite parathyroid adenoma. Surgical intervention was recently recommended due to patient’s DEXA scan showing osteoporosis of the femoral neck. The family history of this patient is pertinent for two sisters; one with pheochromocytoma and the other with papillary thyroid cancer. One of the sisters is a 60 years old diagnosed with pheochromocytoma at 51. Her free normetanephrine level was 682pg/ml and total metanephrine was 727pg/ml at time of diagnosis. Her MRI report showed right adrenal mass measuring 3.5x2.8cm. Laparoscopic right adrenalectomy was done and pathology confirmed pheochromocytoma which was RET negative. She still follows up with endocrinology and calcitonin, chromogranin A and plasma metanephrines have been normal. The second sister is now 53 years old diagnosed with papillary thyroid cancer at age 27 and had total thyroidectomy with pathology confirming papillary thyroid cancer. Discussion: Based on the clinical presentation of these family members, the most likely explanation is familial inheritance. This pattern of inheritance cannot be explained by MEN 2A or 2B due to the absence of medullary thyroid cancer. It has also been reported that this unusual presentation could be a variant of MEN 2A.[i] Due to the family history, close follow up is required to monitor for the possible development of other endocrinopathies in the future.

scholarly journals Incidental papillary thyroid cancer diagnosis in patient with adult-onset Still’s disease-like manifestations

Reumatismo ◽  
2019 ◽  
Vol 71 (1) ◽  
pp. 42-45 ◽  
Author(s):  
R. Tirri ◽  
D. Capocotta
Keyword(s):  
Thyroid Cancer ◽  
Psoriatic Arthritis ◽  
Papillary Thyroid Cancer ◽  
Adult Onset Still’S Disease ◽  
Adult Onset ◽  
Still’S Disease ◽  
Papillary Thyroid ◽  
History Of ◽  
Maculopapular Exanthema ◽  
Adult Onset Still's Disease

Adult onset Still’s disease (AOSD) is a systemic inflammatory disease characterized primarily by a triad consisting of daily fever, arthritis and maculopapular exanthema. The pathogenesis and etiology of AOSD are unknown and the diagnosis, which can be very challenging, is often made by exclusion. Here, we report a case of a 61-year-old woman with a history of mild psoriatic arthritis, fever, arthritis and maculopapular exanthema. Her initial laboratory tests showed neutrophilic leukocytosis, hypertransaminasemia, and markedly elevated levels of the erythrocyte sedimentation rate and C-reactive protein. With a presumptive diagnosis of AOSD, based on Yamaguchi criteria, the patient started an extensive diagnostic work-up to exclude other potential differential diagnoses. With fluorodeoxyglucose (FDG) positron-emission tomography, a thyroid nodule with moderate FDG uptakes was detected. The fine needle aspiration biopsy led to diagnosis of papillary thyroid cancer. The history of psoriatic arthritis, the patient’s age, and atypical features of the skin rash described as not concomitant with fever flares, suggested a diagnosis of paraneoplastic AOSD-like manifestations.

scholarly journals Coexisting Thyroglossal Duct Cyst with Papillary Thyroid Cancer: A Case Report and Literature Review

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Abdullah A. Alarfaj ◽  
Ahmed Zekri ◽  
Ibrahim Alyaeesh ◽  
Ahmed Alomairin ◽  
Abdulrahman Al Naim
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Cancer ◽  
Needle Aspiration ◽  
Central Neck Dissection ◽  
Papillary Thyroid ◽  
Duct Cyst ◽  
Thyroglossal Duct ◽  
History Of ◽  
Detection And Diagnosis

Thyroglossal duct cysts (TGDCs) are common developmental anomalies in which the thyroglossal duct is not obliterated. Coexisting papillary thyroid cancer and TGDC are uncommon and should be investigated thoroughly to rule out TGDC carcinoma. We report a rare case of coexisting papillary thyroid cancer and TGDC in a 48-year-old man, who presented with a history of recurrent mild painful midline neck swelling, and ultrasound (US) revealed a TGDC that was subsequently managed conservatively. On follow-up after 1.6 years, a thyroid US and a fine-needle aspiration (FNA) biopsy were performed, which showed malignant papillary thyroid carcinoma. Total thyroidectomy, the Sistrunk procedure, and central neck dissection were implemented. After three days, the patient was discharged on 150 mg of levothyroxine. Follow-up was unremarkable with no complications. The authors would like to stress the importance of regular TGDC and thyroid gland follow-ups for early detection and diagnosis of thyroid malignancy via clinical examination and US.

scholarly journals A Case of Miliary Nodules, Hemoptysis and Hot Thyroid Cancer: Unusual Presentation of Papillary Thyroid Cancer

2015 ◽  
Vol 7 (3) ◽  
pp. 72-75
Author(s):  
Jesse SL Hu ◽  
Rajeev Parameswaran
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Neck Dissection ◽  
Young Patient ◽  
Papillary Thyroid Cancer ◽  
Braf Mutation ◽  
Unusual Presentation ◽  
Papillary Thyroid ◽  
History Of

ABSTRACT Background Papillary thyroid carcinoma is the commonest thyroid cancer. Patients usually present with thyroid nodule and rarely with hyperthyroidism such that 2009 ATA guidelines recommended that cytological evaluation is not necessary in patients with hyperfunctioning nodules as they rarely harbor malignancy. We report a case of an unusual presentation of metastatic papillary thyroid carcinoma in a young patient. Case presentation A 17-year-old girl, presented to our hospital with 3 days of fever, cough and hemoptysis. Chest X-ray showed extensive miliary nodules and was treated for presumed miliary tuberculosis. Biochemical investigations revealed a hyperthyroid state (fT4 55.7 TSH < 0.02), with negative antibodies (TRAB and TSI). Radioisotope scan showed increased uptake on right lobe. She underwent bronchoscopy and biopsy which revealed metastatic papillary thyroid carcinoma. Clinical examination revealed a small goiter with palpable cervical node at level III on the left. There were no clinical signs of Graves’ disease and she had no history of previous radiation or family history of endocrine disease. Ultrasound revealed multiple hypodense thyroid nodules with microcalcification and increased vascularity. Ultrasound of the neck showed the presence of abnormal lymphadenopathy. She underwent total thyroidectomy, bilateral central neck dissection and left lateral modified neck dissection. Histology showed 1.3 cm papillary thyroid carcinoma involving the left lobe and multifocal papillary thyroid microcarcinomas involving both lobes. Ten out of 27 nodes were involved. She was BRAF mutation positive. She recovered well postoperatively and was rendered hypothyroid. She underwent radioiodine ablation which showed no more disease in the neck but unfortunately there was no uptake in the lung metastases. Conclusion Metastatic papillary thyroid cancer developing in a young patient with hyperthyroidism is extremely rare and suggests a more aggressive behavior as confirmed by BRAF mutation. How to cite this article Hu JSL, Parameswaran R. A Case of Miliary Nodules, Hemoptysis and Hot Thyroid Cancer: Unusual Presentation of Papillary Thyroid Cancer. World J Endoc Surg 2015;7(3):72-75.

scholarly journals Papillary thyroid cancer case masked by subacute thyroiditis

2014 ◽  
Vol 58 (8) ◽  
pp. 851-854 ◽  
Author(s):  
Bekir Ucan ◽  
Tuncay Delibasi ◽  
Erman Cakal ◽  
Muyesser Sayki Arslan ◽  
Nujen Colak Bozkurt ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Papillary Thyroid Cancer ◽  
Needle Aspiration ◽  
Subacute Thyroiditis ◽  
Cervical Region ◽  
Cancer Case ◽  
Papillary Thyroid ◽  
Posterior Aspect

Subacute thyroiditis (SAT) association with thyroid carcinoma has been rarely reported in the literature. We present a patient with SAT and papillary thyroid cancer that was suspected by ultrasonographic evaluation (US) following SAT treatment. A fifty-four-year old female patient referred to our department due to tachycardia, jitteriness and pain in cervical region for the past one month. SAT diagnosis was established by physical examination, laboratory and ultrasonographic findings. After treatment, control thyroid US revealed regression of the hypoechogenic regions seen in both lobes, and a previously unreported hypoechogenic lesion with microcalcification focus that had irregular borders and was not clearly separated from the surrounding parenchyma located in the posterior aspect of the lobe (Elasto score: 4, Strain index: 7.08). Fine needle aspiration biopsy was taken from this nodule; cytology was assessed to be compatible with papillary thyroid carcinoma. Postsurgical pathology evaluation showed a papillary microcarcinoma. SAT may produce ultrasound changes that obscure the coexistence of papillary carcinoma. We recommend that patients with SAT have ultrasonography after they recover. Hypoechogenic regions bigger than 1 cm that are present in the follow-up post-therapy US should be assessed by biopsy.

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