Ocular metastasis from a rare thyroid carcinoma

2014 ◽  
Vol 14 (1) ◽  
pp. 25-30
Author(s):  
Archimedes Lee Agahan ◽  
Ryner Jose Carrillo ◽  
Peter Mark Chao ◽  
Ramil Lising
Keyword(s):  
Retinal Detachment ◽  
Thyroid Carcinoma ◽  
Radical Neck Dissection ◽  
Vitreous Hemorrhage ◽  
Abdominal Ultrasound ◽  
Needle Aspiration ◽  
Neck Mass ◽  
Whole Body ◽  
Ocular Ultrasound ◽  
Computed Topography

Objective: To report a case of primary thyroid carcinoma with ocular metastasis.Methods: This is a case report of a 39-year-old male, who initially presented with a sudden painless loss of vision in the left eye and an anterior neck mass. He was initially diagnosed to have retinal detachment with vitreous hemorrhage based on ocular ultrasound. Fine Needle Aspiration Biopsy of the neck mass initially revealed medullary thyroid carcinoma. Computed topography of the chest and abdominal ultrasound revealed lung and liver metastasis. Whole body bone scintigraphy also revealed bone metastasis.Results: Patient underwent total thyroidectomy with bilateral modified radical neck dissection of the neck mass and vitreous biopsy of the left eye. Histopathology report revealed malignant carcinoma of the thyroid, medullary type while vitreous showed malignant cells from the thyroid. Patient was scheduled to undergo chemotherapy for the widespread metastasis.Conclusions: Ocular malignancy can present in many ways, thus it is necessary to consider it as a differential for cases of retinal detachment and vitreous hemorrhage. Choroidal metastasis from malignant thyroid carcinoma is rare, more so the medullary type.

scholarly journals A Family With a Carotid Body Paraganglioma and Thyroid Neoplasias With a New SDHAF2 Germline Variant

2019 ◽  
Vol 3 (11) ◽  
pp. 2151-2157
Author(s):  
Katherine I Wolf ◽  
Michelle F Jacobs ◽  
Rohit Mehra ◽  
Priya Begani ◽  
Matthew S Davenport ◽  
...  
Keyword(s):  
Succinate Dehydrogenase ◽  
Carotid Body ◽  
Follicular Adenoma ◽  
Needle Aspiration ◽  
Neck Mass ◽  
Whole Body ◽  
Whole Body Mri ◽  
Pathogenic Variants ◽  
Assembly Factor ◽  
Associated Tumors

Abstract At least 30% of all pheochromocytomas (PCCs)/paragangliomas (PGLs) arise in patients with a germline predisposition syndrome. Variants in succinate dehydrogenase subunits A, B, C, and D (SDHA, SDHB, SDHC, and SDHD) are the most common pathogenic germline alterations. Few pathogenic variants have been reported in succinate dehydrogenase assembly factor 2 (SDHAF2). Here, we describe a 30-year-old female patient who presented with a left-sided neck mass, which was later characterized as a carotid body PGL. Genetic testing revealed a likely pathogenic SDHAF2 variant (c.347G>A;p.W116X). Two sisters carried the same pathologic variant, and screening protocols were recommended. Whole-body MRI revealed thyroid nodules; this testing was followed by fine-needle aspiration, which confirmed papillary thyroid carcinoma in one sister and a follicular adenoma in the other. The two sisters then underwent hemithyroidectomy and total thyroidectomy, respectively. Because evidence for pathogenic variants in SDHAF2 causing predisposition to PCC/PGL is limited, we discuss the challenges in mutational variant interpretation and decision making regarding screening for associated tumors.

scholarly journals A Case Report Demonstrating How the Clinical Presentation of the Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma Can Mimic Benign Riedel’s Thyroiditis

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Jennifer Walsh ◽  
Tomas P. Griffin ◽  
Carmel B. Ryan ◽  
James Fitzgibbon ◽  
Patrick Sheahan ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Lymph Nodes ◽  
Inflammatory Cells ◽  
Needle Aspiration ◽  
Neck Mass ◽  
Papillary Thyroid ◽  
Riedel’S Thyroiditis ◽  
Diffuse Sclerosing Variant ◽  
Riedel's Thyroiditis

A 44-year-old female presented with a two-month history of a neck mass, sore throat, hoarseness, and intermittent dysphagia. Examination revealed a “woody” hard swelling arising from the right lobe of the thyroid. Clinically this was felt to be classical Riedel’s thyroiditis (RT). Thyroid ultrasound showed a diffusely enlarged, low echogenicity thyroid with a multinodular goitre. An abnormal nodule extending across the isthmus was noted. Following a nondiagnostic fine needle aspiration, an open core biopsy was performed. This showed dense sclerotic fibrosis punctuated by nodular mononuclear inflammatory cells, which obscured follicular epithelial cells consistent with a fibrosing thyroiditis (Riedel’s thyroiditis). A biopsy of pretracheal lymph nodes showed a sclerotic process throughout the lymph nodes and nests of epithelium bands with squamous differentiation obscured by a fibrous process. These findings raised the differential diagnosis of diffuse sclerosing variant of papillary thyroid carcinoma (DSV-PTC) with metastasis to lymph nodes. A total thyroidectomy and pretracheal lymph node dissection were performed. The final histological diagnosis was DSV-PTC. When managing a patient with presumed RT it is important to consider malignancy in the differential. DSV-PTC is one of the more aggressive forms of thyroid cancer but with early diagnosis and appropriate treatment patients may have excellent outcomes.

scholarly journals Not all neck mass fine-needle aspirations with squamous cells are squamous cell carcinoma; report of a case of recurrent thyroid carcinoma with papillary and squamous components

CytoJournal ◽  
2018 ◽  
Vol 15 ◽  
pp. 23
Author(s):  
Katie Dennis ◽  
Maura O'Neil ◽  
Anthony Harrington
Keyword(s):  
Squamous Cell Carcinoma ◽  
Thyroid Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Clinical History ◽  
Needle Aspiration ◽  
Neck Mass ◽  
Braf V600e ◽  
Fine Needle ◽  
Poor Outcomes

We report a case of a 65-year-old female who had a total thyroidectomy 12 years ago for papillary thyroid carcinoma (PTC) who presented with a recurrent thyroid bed mass. Fine-needle aspiration biopsy yielded malignant cells, consistent with squamous cell carcinoma (SCCa). Surgical resection was performed, and histologic evaluation of the mass showed mixed PTC and SCCa. The tumor cells were positive for BRAF V600E mutation. Thyroid carcinomas with admixed papillary carcinoma and SCCa are rare and are associated with aggressive behavior, high rates of metastasis, and poor outcomes. Although SCCa presenting as a neck mass is relatively common, clinical history and appropriate workup are essential for accurate diagnosis and determination of origin.

scholarly journals Squamous Cell Carcinoma of the Thyroid Gland in an elderly Female

2021 ◽  
Vol 4 (3) ◽  
pp. 01-03
Author(s):  
Talal Mohammed Al-Shahr ◽  
Dema Wahid Hammami ◽  
Mutassem Jaber ◽  
Ghadeer Mazlooh Alenezi
Keyword(s):  
Squamous Cell Carcinoma ◽  
Thyroid Gland ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Cell Cancer ◽  
Radical Neck Dissection ◽  
Needle Aspiration ◽  
Neck Mass ◽  
Complete Excision ◽  
Clear Cases

Background: Squamous cell carcinoma of the thyroid gland is a rare tumor. The tumor may arise as a primary tumor within the thyroid gland. Case Presentation: A 62-years-old lady with history a history of a long-standing left neck mass presented with progressive enlargement of the mass for the last 2 months. The mass was associated with dyspnea, dry cough, and difficulty in swallowing but no change of voice. On examination, it was hard and fixed, and other parts of the general examination were unremarkable. Fine needle aspiration revealed malignant cells with squamous cell cancer (BETHESDA VI). On surgical exploration, there was a mixed cystic and solid mass arising from the left thyroid gland locally invading strap muscles, esophagus and trachea. Complete excision was not possible, debulking was done with modified radical neck dissection. The histopathology showed Invasive poorly differentiated squamous cell carcinoma of the thyroid with cystic changes in background of Hashimoto’s thyroiditis. Conclusion: Thyroid squamous cell carcinoma is a rare malignancy with significant management implications. Less than three hundred clear cases of thyroid squamous cell carcinoma have been reported. In this report we describe one additional case of a thyroid squamous cell carcinoma and provide a comprehensive discussion of the clinical significance, and appropriate surgical management.

scholarly journals Clavicular Metastasis as an Initial Presentation of Papillary Thyroid Cancer

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Russell Fung ◽  
Madeline Fasen ◽  
Firas Warda ◽  
Patrick Natter ◽  
Stacey Nedrud ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Needle Aspiration ◽  
Neck Mass ◽  
Pathology Report ◽  
X Rays ◽  
Papillary Thyroid ◽  
Cancer Specific Survival ◽  
Cell Variant ◽  
The Right

Objective. We present the case of a 44-year-old man with a large neck mass to highlight the unique presentation of papillary thyroid carcinoma (PTC) metastatic to the clavicle. Methods. We reviewed the medical record for a detailed history and physical examination findings. Our radiology colleagues examined the diagnostic imaging studies performed. The pathology team reviewed the neck mass biopsy and the confirmatory surgical pathology after total resection of the mass. Results. A 44-year-old man presented with an enlarging neck mass. Initial X-rays revealed a large soft tissue density mass that extended to the midline of the right clavicle. A neck ultrasound established a 5.4 × 3.6 cm mass with increased vascularity and calcification extending from the thyroid. A CT scan noted the extension of the mass into the adjacent sternoclavicular junction with osteolysis of the middle third of the clavicle and the superior aspect of the sternal body. Fine-needle aspiration revealed a thyroid neoplasm with follicular features and positive immunostaining consistent with thyroid carcinoma. The patient underwent a composite resection of the tumor, including a segmental osteotomy of approximately two-thirds of the medial clavicle. The pathology report confirmed PTC with extrathyroidal extension and clavicle involvement (staged pT4a pN0), with further genomic findings showing positive KRAS mutation. Conclusion. Clavicular metastasis from differentiated thyroid cancer is rare. While the prognosis is generally favorable, various factors, including age greater than 45 years, poor differentiation, follicular thyroid carcinoma, Hurthle cell variant, and extrapulmonary metastasis, have typically been associated with poorer cancer-specific survival.

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.

scholarly journals Papillary Thyroid Carcinoma Presenting with a Right Preauricular and Intracranial Mass

2010 ◽  
Vol 25 (1) ◽  
pp. 26-30 ◽  
Author(s):  
Renato C. Pascual ◽  
Johann F. Castañeda ◽  
Joel A. Romualdez
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Papillary Carcinoma ◽  
Needle Aspiration ◽  
Neck Mass ◽  
Papillary Thyroid ◽  
Intracranial Metastasis ◽  
Papillary Carcinoma Thyroid ◽  
Intracranial Mass ◽  
Carcinoma Metastasis

Objective: To describe a case of a papillary thyroid carcinoma presenting with a pre-auricular and an intracranial mass and review the literature on the metastatic nature and invasiveness of papillary thyroid carcinoma. Method: Design: Case Report Setting: Tertiary Private Hospital Patient: One   Results:  A 46-year-old female with a 12-year anterior neck mass and a two-year right pre-auricular pleomorphic adenoma on fine needle aspiration biopsy was found to have an intracranial mass on CT-scan. Total thyroidectomy and section biopsy of the preauricular mass yielded a final histopathologic report of follicular variant of papillary carcinoma, thyroid gland; and metastatic papillary thyroid carcinoma, follicular type, pre-auricular mass. The condition of the patient precluded neurosurgical intervention and RAI therapy, and she underwent 23 sessions of external radiotherapy using 46Gy with significant diminution in size of the intracranial metastasis. Conclusion: Papillary thyroid malignancy may be an indolent tumor but is capable of distant metastasis. We should be alerted by host and tumor factors which can be predictors of a more radical papillary malignant disease. Keywords: papillary thyroid carcinoma; papillary thyroid carcinoma metastasis; infratemporal metastasis; brain metastasis of papillary carcinoma.

scholarly journals A Report About a 23-year-old Young Mother Suffering From Rare Insular Thyroid Carcinoma

2020 ◽  
Author(s):  
haibin chen ◽  
zhongmin liu ◽  
xiaoyan liang ◽  
rui wu
Keyword(s):  
Thyroid Carcinoma ◽  
Elderly Women ◽  
Needle Aspiration ◽  
Neck Mass ◽  
Maximum Diameter ◽  
Young Mother ◽  
Left Neck ◽  
Poor Differentiation ◽  
Needle Aspiration Cytology ◽  
Histopathological Results

Abstract Background Insular carcinoma of thyroid (ICT) is a rare malignant tumor with poor differentiation of the thyroid , most patients are middle-aged and elderly women. Here is a report of a case involving a young woman suffering from insular thyroid carcinoma.Case report This report is about a 23-year-old young mother who already has three children of hers. she accidentally discovered a left neck mass with slight pain from local compression about half a year ago and did not seek medical treatment. She came to the hospital this time because the neck mass recently increased rapidly and she felt pressure on the trachea, affecting swallowing. Ultrasonography showed that the maximum diameter of the hypoechoic nodules was 61*46mm in the left and no lymph nodes enlargement were seen on both sides.The patient had a partial left thyroidectomy and histopathological results revealed ICT. Therefore, she completed total thyroidectomy and cervical lymph node dissection. The postoperative process was relatively smooth and the patient was successfully discharged.Conclusion：Not all patients with insular thyroid carcinoma have similar imaging findings, so Fine Needle Aspiration Cytology(FNAC)pathological diagnosis is necessary before surgery.

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