scholarly journals Concurrent Papillary and Follicular Thyroid Cancer Presenting as Shoulder Pain

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A888-A888
Author(s):  
Ada Marie Santiago Carrion ◽  
Yanerys Agosto-Vargas
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Shoulder Pain ◽  
Differentiated Thyroid Cancer ◽  
Pathological Fracture ◽  
Papillary Thyroid ◽  
Thyroid Cancers ◽  
Right Lobe ◽  
The Right

Abstract Differentiated thyroid cancer arises from thyroid follicular epithelial cells. It accounts for more than 90% of thyroid cancers. In areas of sufficient iodine nutrition, about 85% of differentiated thyroid cancers are papillary, 10% are follicular and 3% are Hurthle cell carcinomas. The coexistence of different types of thyroid cancer in a single patient is a rare condition. This is the case of a 56 year-old man with medical history of arterial hypertension who presented to clinics with right shoulder pain. Imaging of the right shoulder showed a osteolytic lesion involving the right humerus with associated cortical disruption consistent with pathological fracture secondary to metastatic disease. Bone biopsy showed papillary thyroid carcinoma. Subsequently, ultrasound-guided fine needle aspiration biopsy to a right lobe nodule was performed, which confirmed the presence of papillary thyroid carcinoma. There was also evidence of cervical lymph node involvement. Patient proceeded to total thyroidectomy with neck dissection, and surgical pathology revealed the presence of 2.5 cm right lobe papillary carcinoma and 1.5 cm left lobe follicular carcinoma. Postoperatively, he was found with persistent elevated thyroid-stimulating hormone (TSH) and elevated quantitative thyroglobulin with elevated thyroglobulin antibodies. Patient received therapeutic radioiodine (I-131) for ablation of thyroid cancer. Whole body iodine scan demonstrated residual functioning thyroid tissue within post-thyroidectomy bed, with or without residual carcinoma, and large expansile uptake lesion involving the right humeral head and neck. Therefore, patient will receive a second dose of radioactive iodine. He has been started on thyroid hormone replacement with a goal of TSH <0.1 uIU/mL for high risk American Thyroid Association (ATA) stratification, and has remained clinically euthyroid. Thyroid carcinoma is the most common endocrine malignancy and one of the most rapidly increasing cancers in the United States. This increase in incidence is largely due to incidental detection on diagnostic imaging. Here we present an uncommon case of two distinct thyroid malignancies occurring simultaneously in a patient presenting with a pathological fracture. Synchronous occurrence of two types of differentiated thyroid cancer is a rare event, and has only been reported in case series. Bone metastasis from differentiated thyroid cancer can occur in 2-13% of patients. Despite the therapy for papillary thyroid carcinoma and follicular thyroid carcinoma remain the same, proper identification will lead to prompt therapy and increased survival. Physicians should be aware of this variety.

Carcinoma Showing Thymus-like Differentiation (CASTLE) with Synchronous Papillary Thyroid Carcinoma: A Case Report and Review

2021 ◽  
pp. 014556132110601
Author(s):  
Yuan-Chin Hsu ◽  
Chuen Hsueh ◽  
Wan-Ni Lin ◽  
Tsung-You Tsai ◽  
Shih-Yuan Hung ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Final Diagnosis ◽  
Vocal Cord Palsy ◽  
Anaplastic Thyroid Carcinoma ◽  
Papillary Thyroid ◽  
Thyroid Cancers ◽  
Central Lymph Node Dissection ◽  
The Right ◽  
Immunohistochemical Studies

Carcinoma showing thymus-like differentiation (CASTLE) is a rare malignant tumor that accounts for 0.1%–0.15% of all thyroid cancers. More than half of the patients have tumor extension to adjacent organs, including the recurrent laryngeal nerve, trachea, and esophagus. The diagnosis of CASTLE is based on histology and immunohistochemistry. A 58-year-old female patient complained of hoarseness for one and half years. Right side vocal cord palsy was diagnosed by fiberscopy. Thyroid sonography revealed right thyroid tumors, which were reported to be papillary thyroid carcinoma through FNAC. Total thyroidectomy with central lymph node dissection was performed. Pathologist found 2 isolated malignancy tumors. One patient in the right thyroid lobe had papillary thyroid carcinoma features. The other extrathyroid tumor seemed to be separated from the first tumor and invaded the thyroid capsule. After multiple immunohistochemical studies, PTC synchronous CASTLE was the final diagnosis. Coexisting PTC and CASTLE is very rare. This is the first report to describe a case showing PTC at first, while subsequent pathologic examination revealed the presence of CASTLE in addition to PTC. Since the prognosis of CASTLE is favorable, the treatment is different from other aggressive thyroid cancers, such as poorly differentiated or anaplastic thyroid carcinoma.

scholarly journals Synchronous Thyrolipoma and Papillary Thyroid Carcinoma: A Rare but Significant Event

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1334
Author(s):  
Mariya Kuk ◽  
Chu-Jen Kuo ◽  
Van-Hung Nguyen ◽  
Chien-Chin Chen
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Multinodular Goiter ◽  
Incidental Finding ◽  
Papillary Thyroid ◽  
Solitary Lesion ◽  
Neck Lymph Node ◽  
Thyroid Carcinomas ◽  
Right Lobe ◽  
The Right

The presence of adipocytes within thyroid glands is a rare finding seen in thyrolipoma, diffuse lipomatosis, or thyroid teratoma. Although some cases present with multinodular goiter or autoimmune thyroiditis, the exact cause has not yet been elucidated. Among reported cases, thyrolipomas mainly occur in females and usually present as a solitary lesion. However, a few reported cases had coexisting papillary thyroid carcinomas. Herein, we present a 51-year-old female with synchronous thyrolipoma (2.0 × 1.5 × 1.3 cm) and papillary thyroid carcinoma (0.7 × 0.6 × 0.6 cm) within the same thyroid lobe. She had diabetes mellitus and hypertension and complained of anterior neck enlargement and discomfort for three months. Thyroid sonography showed multiple hypoechoic nodules, one of which was heterogeneous and ill-defined. Fine needle aspirate cytology for the ill-defined nodule was suspicious for papillary thyroid carcinoma. She subsequently received radical thyroidectomy and neck lymph node dissection. Histopathologically, one thyrolipoma and one papillary thyroid carcinoma were identified in the right lobe of the thyroid gland without metastases of lymph nodes, while other nodules were multinodular goiter. Notably, thyrolipoma may not be simply an incidental finding but might coexist with thyroid carcinomas. A brief review of the pertinent literature of prior reports is also provided.

scholarly journals Diffuse sclerosing variant of papillary thyroid carcinoma: a case report

2020 ◽  
Author(s):  
Siyao Wang ◽  
Rui Wang ◽  
Ruize Sun ◽  
Xiaoman Luo ◽  
Yue Xuan ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Papillary Thyroid ◽  
Case Presentation ◽  
Diffuse Sclerosing Variant ◽  
Color Duplex Ultrasonography ◽  
Right Lobe ◽  
Final Histological Diagnosis ◽  
The Right ◽  
Medical University

Abstract Background: The diffuse sclerosing variant of papillary thyroid carcinoma (DSVPC) is a rare variant of papillary thyroid carcinoma with features of strong ability of invasion, metastasis, relapse, and mortality. Its diagnosis is difficult to obtain because of the special differentiation state of the cancer cells. Case Presentation: A 21-year-old woman arrived at the First Affiliated Hospital of China Medical University in October 2019 because of a peach-pit-sized mass that she had noticed 1 month before. Color duplex ultrasonography findings suggested a thyroid nodule. Conclusions: Based on findings of the specialist examination, physical examination, and thyroid ultrasonography, the patient was initially diagnosed with thyroid neoplasm. Under general anesthesia, thyroidectomy was performed, removing the right lobe and isthmus, and biopsy specimens were obtained from lymph node groups III, IV, and VI on the right side. The final histological diagnosis was DSVPC.

scholarly journals Incidence and predictors of right paraesophageal lymph node metastasis of N0 papillary thyroid carcinoma located in the right lobe

2013 ◽  
Vol 60 (3) ◽  
pp. 389-392 ◽  
Author(s):  
Yasuhiro Ito ◽  
Mitsuhiro Fukushima ◽  
Takuya Higashiyama ◽  
Minoru Kihara ◽  
Yuuki Takamura ◽  
...  
Keyword(s):  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Lymph Node Metastasis ◽  
Thyroid Carcinoma ◽  
Papillary Thyroid ◽  
Node Metastasis ◽  
Right Lobe ◽  
The Right ◽  
Paraesophageal Lymph Node

scholarly journals Prevalence of papillary thyroid cancer in subacute thyroiditis patients may be higher than it is presumed: retrospective analysis of 137 patients

2018 ◽  
Vol 52 (3) ◽  
pp. 257-262 ◽  
Author(s):  
Nurdan Gül ◽  
Ayşe Kubat Üzüm ◽  
Özlem Soyluk Selçukbiricik ◽  
Gülçin Yegen ◽  
Refik Tanakol ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Differentiated Thyroid Cancer ◽  
Histopathological Examination ◽  
Needle Aspiration ◽  
Subacute Thyroiditis ◽  
Papillary Thyroid ◽  
Small Series ◽  
Male Patients

Abstract Background The association of subacute thyroiditis (SAT) and papillary thyroid carcinoma is a rare finding. In this study, we aimed to investigate the prevalence of differentiated thyroid cancer in a cohort of patients followed with the diagnosis of SAT. Patients and methods We retrospectively screened medical records of Endocrinology and Metabolism outpatient clinic in the past 20 years for patients with SAT. Patients with nodules and suspicious ultrasonography findings who underwent fine needle aspiration biopsy (FNAB) and operated due to malignancy risk were identified. Results We identified 137 (100 females, 37 males) patients with reliable records to confirm the diagnosis of SAT. The mean age of female patients was 41.1 ± 9.1 (range, 20–64) and of male patients was 43.0 ± 9.3 (range, 20–65). One or more FNAB was performed in 23 of the patients (16.8%) at the beginning and/or during the follow-up period when needed. Seven patients with suspicious FNAB findings were operated, and histopathological examination of the nodules confirmed the diagnosis of papillary thyroid carcinoma in 6 patients (4.4%). Conclusions Our observations suggesting a relatively higher prevalence of thyroid cancer in a small series of SAT patients warrant further studies to identify the real frequency of differentiated thyroid cancer and its association with inflammatory pathogenesis of SAT. This finding is compatible with the trend of increased thyroid cancer incidence all over the world. A repeat ultrasonography after resolution of clinical and inflammatory findings, and FNAB should be recommended to all patients with suspicious nodules.

scholarly journals Fracture of the Humeral Bone as the First Clinical Presentation of Metastatic Papillary Thyroid Carcinoma in Ibadan

2019 ◽  
pp. 1-7
Author(s):  
Mustapha Akanji Ajani ◽  
Babatope Lanre Awosusi ◽  
Ebenezer O. Fatunla ◽  
Omolade O. Adegoke ◽  
Ayodeji A. Salami
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Pathological Fracture ◽  
Clinical Presentation ◽  
Bone Biopsy ◽  
Pathologic Fracture ◽  
Metastatic Carcinoma ◽  
Papillary Thyroid ◽  
High Index Of Suspicion

Papillary thyroid carcinoma is the commonest type of thyroid cancer representing 75 to 85 per cent of all thyroid cancer cases. It is often well-differentiated, slow-growing, and localized, although it can metastasize. This is a case of a 49-year-old male who presented with a pathological fracture of the left humerus. A bone biopsy was done at the surgery which had a histological diagnosis of metastatic thyroid carcinoma. A total thyroidectomy was subsequently done and was histologically reported as a follicular variant of papillary thyroid carcinoma. The patient was clinically stable post-thyroidectomy and was discharged home on the 10th postoperative day and he is currently being followed-up in the surgical outpatient clinic. Pathological fracture as the initial clinical presentation is an unusual manifestation of metastatic thyroid carcinoma; therefore a high index of suspicion is needed to make this diagnosis. In any patient presenting with a pathologic fracture, the possibility of metastatic carcinoma from the thyroid gland should always be considered.

scholarly journals Serum TSH and Risk of Papillary Thyroid Cancer in Nodular Thyroid Disease

2012 ◽  
Vol 97 (4) ◽  
pp. 1134-1145 ◽  
Author(s):  
Emilio Fiore ◽  
Paolo Vitti
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Thyroid Disease ◽  
Differentiated Thyroid Cancer ◽  
Nodular Goiter ◽  
Papillary Thyroid ◽  
Thyroid Malignancy ◽  
The Relationship ◽  
Serum Tsh

Context: TSH is the main factor involved in the control of proliferation of thyrocytes. Recently, a strong relationship between serum TSH and risk of thyroid malignancy has been reported. Objectives: The aim was to review published papers about the relationship between serum TSH and frequency of differentiated thyroid cancer. Evidence Acquisition: PubMed was used to identify studies focused on the relationship between TSH and differentiated thyroid cancer. Evidence Synthesis: In patients with nodular thyroid disease, the risk of thyroid malignancy increases with serum TSH, and even within normal ranges, higher TSH values are associated with a higher frequency and more advanced stage of thyroid cancer. The likelihood of papillary thyroid carcinoma is reduced when TSH is lower, as in thyroid autonomy, and increased when TSH is higher, as in thyroid autoimmunity. Treatment with l-thyroxine (LT4), which reduces serum TSH, is associated with significantly lower risk of developing clinically detectable thyroid cancer. Conclusions: TSH plays a key role in the development of clinically detectable thyroid cancer, and LT4 treatment reduces the risk of thyroid malignancy in patients with nodular thyroid disease. According to the guidelines of the main scientific societies, LT4 therapy is not currently recommended for the treatment of patients with nodular goiter. Even if the available data are not sufficient to advise LT4 treatment in all patients with nodular goiter with the aim of reducing the risk of papillary thyroid carcinoma, we propose that this indication should be reconsidered, taking into account recent evidence reported in the literature.

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