Endocrine Abstracts

Introduction: Mixed thyroid carcinoma is an entity that corresponds to tumors with a double component: one of the vesicular type (Tg +) and the other of the medullary type (CT +). We report the occurrence of papillary and medullary thyroid carcinoma in a 44-year-old patient. This coexistence is considered rare.

Case: A 44-year-old patient underwent a thyroidectomy due to a goiter, histopathological examination identified multifocal papillary carcinoma, multiple colloidal nodules, with metastases in supra isthmic and left supraclavicular lymph nodes. A complement by iratherapy was performed, with bilateral cervical lymph node dissection, which revealed: bilateral jugular chain metastases, three metastases in the recurrent chain with capsule invasion. The mediastinal lymph node dissection showed seven metastases with capsule invasion, immunohistochemistry confirmed the presence of calcitonin. For the extension assessment: Postoperative calcitonin =228 ng / l. CT scan revealed: empty thyroid bed, bilateral submandibular nodes, intraparenchymal and subpleural lung nodules, bilateral axillary lymphadenopathy, Hepatic steatosis and an osteocondensation lesion at the inferior angle of the left scapula. Bone scintigraphy: no sign of secondary bone localization.

Discussion: The Simultaneous occurrence of medullary carcinoma with a differentiated carcinoma of the thyroid, although exceptional, should always be considered as it could change the therapeutic approach and the prognostic evaluation.