ECE2019 Poster Presentations Thyroid 2 (70 abstracts)
Paradoxical first manifestation of papillary thyroid carcinoma in a young male patient
Georgios Boutzios 1 , Apostolos Angelis 2 , Elli Karatza 2 , Eleni Papaoiconomou 1 , Elefterios Spartalis 3 , Stylianos Kykalos 2 & Gerasimos Tsourouflis 2
1Department of Pathophysiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece; 2Second Department of Propaedeutic Surgery, Medical School, National and Kapodistrian University of Athens, Athens, Greece; 3Laboratory of Experimental Surgery and Surgical Research ‘N. S. Christeas’, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Introduction: Most thyroid neoplasms arise from follicular cells and are well differentiated. We present an interesting case of a rare first manifestation of Papillary Thyroid Carcinoma (PTC) as a cervical cystic mass, as well as the therapeutic approach.
Material-method: A 29 year-old-male, without personal or family history for PTC and no history of neck radiation referred to our department because of a slow growing right lateral cervical mass in the last 18 months. Sonography and CT imaging showed a mass with the characteristics of a lymphangioma. The patient was submitted to surgical excision. The mass contained straw-colored fluid and the histology revealed a follicular thyroid carcinoma with cystic lesions. Thick lymphatic tissue in the cystic wall posed the suspicion for lymphatic metastasis. Postoperatively, the patient underwent a thyroid ultrasound and the result revealed the presence of two suspicious nodes of the thyroid gland, as well as the presence of pathological lymph nodes of the central neck and the lateral compartments, between 2–4. A total thyroidectomy with radical central and right neck dissection was performed.
Results: Histology of the thyroid gland showed the presence of multiple foci of follicular cancer of the right lobe with focal invasion of the surrounding fat tissue and metastatic invasion of 4 out of the 37 excised lymph nodes.
Conclusions: The presentation of this case has the intention to stress out the high suspicion for malignancy that every physician must have, when examining a cervical mass, despite the possible negative imaging report. We would also like to annotate that the neck ultrasound, performed by an expert radiologist, is the gold standard examination on differentiating various pathologies of the thyroid gland.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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