Thyroid Papillary Carcinoma and Hyperthyroidism: A Case Study

Background: Concurrent thyroid cancer and hyperthyroidism is a rare finding. The frequency of this association is very variable. A rare case of papillary thyroid cancer associated with hyperthyroidism is described here. Case: A 49-year-old male presented to the authors’ outpatient clinic with complaints of a painless left-sided anterior neck swelling that had persisted for the past 8 months. He also reported weight loss for the same duration. The anterolateral swelling was non-tender, asymmetrical, mobile, and rubbery. Investigations: Biochemical analysis confirmed hyperthyroidism. Ultrasound examination of the neck showed a well-defined, solid, and cystic lesion in the left lobe and isthmus of thyroid gland. The solid portion had few specks of calcification. A radioactive thyroid scan showed increased tracer uptake in the left lobe. Papillary carcinoma of thyroid origin was discovered after fine-needle aspiration of the left anterior cervical lymph node. After preparation, a total thyroidectomy was done. Examination of histopathology confirmed papillary thyroid carcinoma. Treatment: Following radioactive thyroid ablation, the patient was started on suppressive doses of thyroxine daily. Conclusion: Although thyroid cancer with hyperthyroidism is a rare finding, it should not be disregarded. To avoid missing this unusual yet uncommon discovery, a detailed history and physical examination should be performed, as well as all required investigations.

Thyroid Swellings Undergoing Thyroidectomy in a Tertiary Hospital of Nepal: A Retrospective Study of Distribution and Prevalence of Malignancy

Introduction: Thyroid nodules brought to a hospital are checked for cancer. A post-operative histological examination is a gold standard for diagnosing thyroid lesions. Treatment is aided by a prior understanding of the disease’s underlying pattern. Objective: A retrospective study was done to determine the prevalence and distribution of malignancy in suspicious thyroid nodules. Methods: The study was conducted at Ganesh Man Singh Memorial Academy of ENT- Head and Neck studies from August 2017 to March 2020. All the subjects (n=183) presenting with a thyroid nodule and who had post-operative histopathological evaluation available were recruited in the study. The proportion and percentage of findings of Fine Needle Aspiration Cytology (FNAC) and histopathological evaluation were done. The distribution of histopathological observation was also analyzed in terms of age group and gender. Results: The mean age of study participants was 40.23 ± 13.77 years (n=183). The predominance of women was notable. In about 98 (53.55%) of the patients who underwent thyroidectomy, a benign lesion was found, but the most common finding was papillary carcinoma (40.98%). In the age group below 50 years, papillary carcinoma was most common. Among people older than 50, colloid goiter was more common. Follicular and medullary carcinomas were only observed in female participants. Gender did not appear to be associated with malignancy (p=0.99). Follicular adenomas were noted to have the youngest mean age. Conclusions: We observed a high prevalence of malignancy, particularly papillary carcinoma in clinically suspected thyroid nodules of a tertiary hospital in Nepal. Keywords: Colloid Goiter; malignancy; papillary carcinoma; thyroid cancer; thyroid nodule.

Giant paratubaric cysts

Giant paratubaric cysts are mostly benign tumors, with incidence of 10%. The incidence rate of these neoplasms is 2% to 3% including cystitis, papillary carcinoma and serous papillary neoplasms, the course of disease begins with abdominal pain or increase in size of lower hemi abdomen, becoming complicated in approximately 3% of cases. The diagnosis is made with transabdominal or transvaginal ultrasound, abdominal and pelvis tomography or magnetic resonance. The treatment of small cysts is expectant and the large size is surgical way. We present the case of a 35-year-old woman who began her current condition three years after her pregnancy, with urination urgency, abdominal pain and sensation of abdominal mass, who was diagnosed and protocolized in a public second level hospital in Mexico City, treated with opened surgery, and good postoperative evolution.