ECE2014 Poster Presentations Clinical case reports Thyroid/Others (72 abstracts)
Medullary and papillary thyroid cancer metastasis in the same lymph node: case report
Merve Yilmaz 1 , Arzu Gedik 2 , Ahmet Omer Ikiz 3 , Tugba Gumus 4 , Mehmet Calan 4 , Ulku Aybüke Tunc 4 , Serafettin Canda 5 , Ahmet Alacacioglu 6 , Abdurrahman Cömlekci 4 & Tevfik Demir 4
1Endocrinology Department, Gazi Government Hospital, Samsun, Turkey; 2Endocrinology Department, Agri Government Hospital, Agri, Turkey; 3KBB Department, Medical Faculty Dokuz Eylul University, Izmir, Turkey; 4Endocrinology Department, Medical Faculty Dokuz Eylul University, Izmir, Turkey; 5Pathology Department, Medical Faculty Dokuz Eylul University, Izmir, Turkey; 6Medical Onkology Department, Izmir Katip Celebi University, Izmir, Turkey.
Introduction: Two tumors originating from different cells in the thyroid to metastasis same lymph nodes is very rare. We aimed to present that the same lymph node metastasis of medullary and papillary thyroid in a case.
Case: A 4-year-old male presented with backache without a formerly known disease, has no other property in the patient’s history. Vertebra BT was taken and T2, T4, T6 vertebral metastasis have been detected. Malignant cytology was seen in the biopsy from T4 vertebrae. Thyroid ultrasound was performed to determine primary tumor foci. Malignant nodule (10×23×23 mm) in the left lobe of the thyroid gland and bilateral multiple pathological lymph nodes in the neck were shown. Fine needle aspiration (FNA) biopsy of the thyroid has been reported as malign. Also medullary thyroid cancer (MTC) was thought because of the height of CEA and calcitonin (Calcitonin >2000 pg/ml, CEA 538.3 ng/ml). Malignant involvement was detected in the left lobe of the thyroid gland and increased FDG uptake was determined in the cervical, mediastinal, hilar, abdominal lymph nodes and multiple bones using PET–CT. The patient underwent total thyroidectomy and neck dissection. Multifocal papillary thyroid carcinoma (PTC) in the right lobe, multifocal MTC in the left lobe and isthmus, MTC metastasis in the multiple lymph nodes, PTC and MTC metastasis association in the central area were reported as a result of pathologic. The patient underwent with external radiotherapy for bone metastases. Then systemic chemotherapy and sorafenib was given by medical oncology.
Conclusion: The MTC originating from parafollicular C cells of the thyroid and PTC originating from follicular cells of the thyroid to metastasis to same lymph nodes is very rare. This situation can be explained by the activation of a common tumorigenic pathway for both follicular and parafollicular cells or coincidental.
Volume 35
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Endocrine Abstracts
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