scholarly journals A Rare Case of Aggressive Ectopic Thyroid Cancer in a Patient With Graves Disease

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A878-A879
Author(s):  
Ejaz Mahmood ◽  
Catherine Anastasopoulou ◽  
Nissa Blocher
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Gland ◽  
Papillary Thyroid Cancer ◽  
Mediastinal Mass ◽  
Case Reports ◽  
Thyroid Tissue ◽  
Ectopic Thyroid ◽  
Graves Disease ◽  
Papillary Thyroid ◽  
Ectopic Thyroid Tissue

Abstract Background: Ectopic thyroid tissue is a rare entity with a prevalence of 1 per 300,000 persons. Malignancy in ectopic thyroid tissue is reported in <1% of these cases.[1] We report a case of aggressive papillary carcinoma in ectopic thyroid gland in a patient with Graves’ disease. Case: A 65-year old woman was incidentally found to have a 3.1 cm mass with coarse calcifications in the superior mediastinum on CT scan of chest. Ultrasound confirmed the presence of hypoechoic mass which was separate from thyroid. Additionally, a 0.5cm TI-Rad 4 left thyroid lobe nodule was found. FNA of the mediastinal mass was suspicious for follicular thyroid neoplasm. Thyramir testing was positive for BRAF V600E and TERT c-124C>T mutations. Thyroid function tests showed frank hyperthyroidism and elevated thyroid stimulating immunoglobulins. Thyroid uptake and scan showed diffuse uptake of 67% at 24 hours. The patient underwent simultaneous excision of mediastinal mass and total thyroidectomy. The pathology of mediastinal mass showed papillary thyroid cancer with tall and sclerosis features with one involved lymph node. The pathology of thyroid gland did not show any malignancy. She was treated with 100 mCi I-131. Post treatment Whole Body Nuclear Scan after treatment revealed metastatic disease in left lower lung area. Discussion: Ectopic thyroid gland is usually found anywhere between forman caecum and mediastinum. It is rare to find ectopic thyroid tissue in the presence of eutopic thyroid gland which can create a diagnostic dilemma. Only a very few case reports of thyroid cancer arising from ectopic thyroid tissue have been reported. Our case is unique as the eutopic thyroid gland had Graves’ disease with no malignancy but the ectopic thyroid tissue developed aggressive papillary thyroid cancer. There are no specific guidelines for the management of carcinoma in ectopic thyroid glands, possibly due to the rarity of the condition. Our case has a clear metastasis to the lungs. However, it is important to differentiate ectopic thyroid tissue with carcinoma from thyroid cancer metastasis which can be difficult at times. Without specific guidelines for the management of cancer in ectopic thyroids, an individualised approach can be taken using the same therapeutic principals used in the management of eutopic thyroid cancer. Additionally, a finding of a normal thyroid gland or a benign condition in the thyroid gland should not exclude the diagnosis of malignancy in ectopic thyroid tissues. 1) Vázquez, Oscar R., et al. “Ectopic papillary thyroid cancer with distant metastasis.” Case reports in endocrinology 2018 (2018).

Papillary thyroid carcinoma in a lateral neck cyst: primary of ectopic thyroid tissue versus cystic metastasis

2013 ◽  
Vol 127 (7) ◽  
pp. 724-727 ◽  
Author(s):  
J J Xu ◽  
K Kwan ◽  
K Fung
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Gland ◽  
Thyroid Carcinoma ◽  
Papillary Carcinoma ◽  
Thyroid Tissue ◽  
Ectopic Thyroid ◽  
Cystic Degeneration ◽  
Lateral Neck ◽  
Papillary Thyroid ◽  
Ectopic Thyroid Tissue

AbstractObjective:To review the diagnosis of primary papillary carcinoma of ectopic thyroid tissue within branchial cleft cysts, and to discuss the diagnostic challenge of differentiating this condition from metastatic disease when an occult microcarcinoma is found in the thyroid gland.Methods:These comprise a case report and a literature review. We present the case of a 75-year-old woman with papillary thyroid carcinoma within the wall of a recurrent, 15 cm, lateral neck cyst.Results:Histological examination of the patient's thyroid gland found a 0.5 mm papillary thyroid microcarcinoma.Conclusion:Our differential diagnosis was primary papillary carcinoma arising from ectopic thyroid tissue, or metastatic cystic degeneration of a lateral lymph node. We make an argument for the former.

scholarly journals MON-439 Graves’ Disease and Papillary Thyroid Cancer: A Rare Clinical Case?

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Natalia Volkova ◽  
Ilia Davidenko ◽  
Irina Dzherieva ◽  
Alexander Zibarev ◽  
Lilia Ganenko ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Gland ◽  
Papillary Thyroid Cancer ◽  
Clinical Case ◽  
Diagnostic Methods ◽  
Suppressive Therapy ◽  
Graves Disease ◽  
Papillary Thyroid ◽  
Body Type ◽  
Target Values

Abstract Background: Nodules on the background of Graves’ disease are less common among men than among women, but more than one in three patients have carcinoma. Despite the improvement of diagnostic methods, most often thyroid cancer is a random histological finding after thyroidectomy for Graves’ disease. Clinical case: A 55-year women complained of discomfort in the neck, sweating, irritability, palpitation. From anamnesis: in 2012 she was diagnosed with thyrotoxicosis syndrome. For 5 years, the patient was treated with thyrostatics, but when trying to reduce the dose, the syndrome of thyrotoxicosis recurred. In March 2017, the patient’s condition worsened, at the time of treatment she took Thyrosol 30 mg/day. Objectively: hypersthenic body type, BMI 33 kg/m2. Thyroid gland visually was increased in volume, dense with palpation, homogeneous, mobile. Elevated titer of antibodies to the TSH receptor was discovered, according to the ultrasound - increase thyroid gland 30.2 cm3, hyperechogenic formation of the left lobe 10х10х9 mm with hypoechoic rim, clear smooth contours, intranodular blood flow. As a result, the Graves’ disease, goiter grade 2, manifest thyrotoxicosis was verified, surgical treatment was recommended. Thyroidectomy, histological examination was performed: Graves’ disease was confirmed, papillary microcarcinoma with metastasis to 1 regional lymph node was revealed. Diagnosed: papillary thyroid cancer I st (pT1aN1aM0x), 2 clinical group. The patient was prescribed suppressive therapy with L-thyroxine 100 µg/day, against which after 3 months TSH reached the target values (0.2–0.5 Mme/l). Taking into account the histological characteristics of the tumor, the nature and volume of the lesion, age, the patient belongs to the group of intermediate cancer risk of progression of cancer. According to scintigraphy residual functioning thyroid tissue (20x15 mm) was detected. Radioiodine therapy was carried out in a specialized hospital. Suppressive therapy of L-thyroxine 150 µg/day, target values of TSH 0.1 - 0.5 Mme/l was recommended. After 6 months, TSH reached target values, and according to the results of ultrasound of thyroid gland no data for structural relapse was found. Conclusion: Patients with long-existing, often recurrent Graves’ disease and questionable effect of conservative therapy, in the presence of nodular formation should be assigned to the risk group for the presence of thyroid cancer and carefully examined, because the need for further surgery depends on it.

Simultaneous medullary and papillary thyroid cancer in Graves-Basedow disease. Two case reports

2018 ◽  
Author(s):  
Roxana Dumitriu ◽  
Eugenia Petrova ◽  
Andra Buruiana ◽  
Mircea Ghemigian ◽  
Adina Ghemigian
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Cancer ◽  
Case Reports ◽  
Papillary Thyroid

scholarly journals Developing anterior mediastinum mass after orthotopic thyroidectomy: a case report

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Rita Meira Soares Camelo ◽  
José Maria Barros
Keyword(s):  
Thyroid Gland ◽  
Total Thyroidectomy ◽  
Thyroid Tissue ◽  
Anterior Mediastinum ◽  
Ectopic Thyroid ◽  
Ectopic Thyroid Tissue ◽  
Ectopic Tissue ◽  
Thyroid Scan ◽  
Imaging Results ◽  
Adjacent Structures

Abstract Background Ectopic thyroid tissue is a rare embryological aberration described by the occurrence of thyroid tissue at a site other than in its normal pretracheal location. Depending on the time of the disruption during embryogenesis, ectopic thyroid may occur at several positions from the base of the tongue to the thyroglossal duct. Ectopic mediastinal thyroid tissue is normally asymptomatic, but particularly after orthotopic thyroidectomy, it might turn out to be symptomatic. Symptoms are normally due to compression of adjacent structures. Case presentation We present a case of a 66-year-old male submitted to a total thyroidectomy 3 years ago, due to multinodular goiter (pathological results revealed nodular hyperplasia and no evidence of malignancy), under thyroid replacement therapy. Over the last year, he developed hoarseness, choking sensation in the chest, and shortness of breath. Thyroid markers were unremarkable. He was submitted to neck and thoracic computed tomography, magnetic resonance imaging, and radionuclide thyroid scan. Imaging results identified an anterior mediastinum solid lesion. A radionuclide thyroid scan confirmed the diagnosis of ectopic thyroid tissue. The patient refused surgery. Conclusions Ectopic thyroid tissue can occur either as the only detectable thyroid gland tissue or in addition to a normotopic thyroid gland. After a total thyroidectomy, thyroid-stimulating hormone can promote a compensatory volume growth of previously asymptomatic ectopic tissue. This can be particularly diagnosis challenging since ectopic tissue can arise as an ambiguous space-occupying lesion.

scholarly journals Submandibular ectopic thyroid gland: an uncommon presentation

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Inès Riahi ◽  
Rim Fradi ◽  
Ibtissem Ben Nacef ◽  
Ahlem Blel
Keyword(s):  
Thyroid Gland ◽  
Thyroid Tissue ◽  
Ectopic Thyroid ◽  
Lingual Thyroid ◽  
Submandibular Region ◽  
Case Presentation ◽  
Thyroglossal Duct ◽  
Common Presentation ◽  
Ectopic Thyroid Tissue ◽  
Uncommon Presentation

Abstract Background Ectopic thyroid is a developmental anomaly of the thyroid gland of embryological origin. Instead of having a pretracheal situation, thyroid tissue is elsewhere, most commonly in the median cervical line along the course of the thyroglossal duct. Lingual thyroid is the most common presentation. Ectopic thyroid tissue in the submandibular region has been rarely reported. Case presentation We report herein a case of a 65-year-old man admitted to our department with a complaint of a painless swelling in the left submandibular region. Conclusions Thyroid gland ectopia should be considered among the differential diagnoses of submandibular swelling. Ectopic thyroid tissue can present with the same pathology affecting the normal thyroid gland such as malignancy and hyperthyroidism.

scholarly journals Ectopic thyroid tissue presenting as an external auditory canal mass

2019 ◽  
Vol 5 (2) ◽  
pp. 476
Author(s):  
Nishikanta Verma ◽  
Samuel Devanesan Abishegam ◽  
Abdul Razak Bin Haji Ahmad
Keyword(s):  
Thyroid Gland ◽  
Thyroid Tissue ◽  
The Body ◽  
Ectopic Thyroid ◽  
Thyroid Function Tests ◽  
External Ear ◽  
Ear Canal ◽  
Developmental Defects ◽  
External Ear Canal ◽  
Ectopic Thyroid Tissue

<p class="abstract">An ectopic thyroid is a rare occurrence with a majority of ectopic thyroid tissue located in the lingual region or in the midline. The abnormal sites represent developmental defects in migration from the floor of the primitive foregut at the foramen caecum of the tongue to the final pre-tracheal position of the gland. A few cases of ectopic thyroid tissue have also been reported from sites seemingly unrelated to the normal development of the thyroid gland.  We report a case of ectopic thyroid in the external ear canal, which presented as a small reddish mass in the external ear canal. To the best of our knowledge, this is the first such reported case in literature and adds to the body of knowledge in such cases. Although such a finding is exceedingly rare, the authors recommend routine histopathology in all cases of polyps in the external canal and standard investigation for the status of the residual thyroid gland via isotope scans, ultrasonography or thyroid function tests.</p>

scholarly journals Papillary thyroid cancer patient with hyperthyroidism - a case study

2019 ◽  
Vol 10 (4) ◽  
pp. 3178-3181
Author(s):  
Punitha S ◽  
Vedha pal jeyamani ◽  
Sindhu S ◽  
Bhuvaneshwari P ◽  
Arshath A
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Cancer ◽  
Thyroid Tissue ◽  
Needle Aspiration ◽  
Good Prognosis ◽  
Thyroid Stimulating Hormone ◽  
Papillary Thyroid ◽  
Thyroid Cancer Patient ◽  
Chief Complaints ◽  
Post Menopausal

Thyroid carcinoma is the majority widespread endocraine malignancy in that papillary thyroid cancer is a well-differentiated type. Since hyperthyroidism protects from thyroid cancer due to lack of reproduction of thyroid tissue by the thyroid-stimulating hormone. The papillary carcinoma is the fast-growing and metastases to local region rapidly. A 60 years old post menopausal women with a known case of hypertension of past 6 years on treatment and with hyperthyroidism of past 2 months was presented in the outpatient department in the hospital with chief complaints of mass in the neck with dyphagia, cough, breathlessness, sense of fullness and odynophagia of past 2 weeks. On physical and general examination patient found with diffuse thyroid swelling with enlarged right sided lymph node. The patient was diagnosed with papillary thyroid caricinoma with various investigation reports includes CT Scan, Immouno history chemistry reports, Histopathology and Two fine-needle aspiration biopsies. The patient has undergone 6 cycles of chemotherapy with the corticosteroids, anti-cancer drugs which includes Vincristine, Cyclophosphamide, Doxorubicin, anti- emetic drugs and also with H2 receptor blockers. The papillary thyroid cancer is common and occurs predominantly in females than in males and with good prognosis and decreased death rates. The higher level of thyroid function is very rare in case of PTC.

Papillary Thyroid Carcinoma in Ectopic Thyroid Tissue Within a Suspected Cervical Paraganglioma

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Marcel Ernesto Sambo Salas ◽  
Diego Muñoz Moreno ◽  
Laura Gonzalez Fernandez ◽  
Patricia Nuñez Ramos ◽  
Maria Cebollero Presmanes
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Thyroid Tissue ◽  
Ectopic Thyroid ◽  
Papillary Thyroid ◽  
Ectopic Thyroid Tissue
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