Introduction. Thyroid paraganglioma is a very rare malignant neuroendocrine
tumor. Immunohistochemical features of thyroid paraganglioma are helpful for
the diagnosis. Case report. A 69-year-old female came to hospital with the
presence of a growing thyroid nodule of the left lobe. Ultrasonic neck
examination showed 5 cm hypoechoic nodule in the left thyroid lobe. Thyroid
scintigraphy showed a big cold nodule in the left lobe. Computed tomography
(CT) scan showed left lobe thyroid tumor with tracheal deviation on the
right site. Extended total thyroidectomy was done. Intraoperative
consultation with the pathologist confirmed thyroid cancer. The pathologist
diagnosed thyroid paraganglioma on the base of immuohistochemical
investigation. This thyroid paraganglioma was positive for neuron-specific
enolase, chomogranin A, synaptophysin, and S-100 protein highlighted the
sustentacular cells. Tumor cells were nega-tive for thyroglobulin,
epithelial membrane antigen, cytokeratin, calcitonin, and carcinoembryonic.
After the surgery the patient was treated with chemotherapy, peptide
receptor radionuclide therapy, and permanent TSH suppressive therapy. The
patient was followed with measurements of thyroid hormone and serum
neuron-specific enolase, chromogranin A level, every 6 months. Gastroscopy,
colonoscopy, chest and abdomen CT scan as well as further tests (chest
x-ray, ultrasound of the neck, and whole body octreotide scintigraphy) were
done. No primary neuroendocrine tumor in digestive sistem or in the chest
was found. After more than 3 years the patient has no evidence of the
recurrent disease. Conclusion. Radical resection of thyroid paraganglioma,
followed by chemotherapy and peptide receptor radionuclide therapy, should
be considered the treatment of choice in patients with thyroid gland
paraganglioma.
Paraganglioma of the thyroid gland: A case report
