ECE2021 Audio Eposter Presentations Thyroid (157 abstracts)
Follicular thyroid carcinoma with lymphatic and macroscopic vascular extension
Dardouri Teheni 1 , Nouira Manel 1 , Chouchane Lobna 2 , Boudrigua Hajer 1 , Ezzine Abir 1 , Charfi Hela 1 , Sfar Raja 1 , Ben Fredj Maha 1 , Abdelkefi Mohamed 2 & Chatti Kaouthar 1
1Hospital University Sahloul, Nuclear Medecine, Sousse, Tunisia; 2Hospital University Farhat Hached, ENT department, Sousse, Tunisia
Introduction and aims
Macroscopic angioinvasion associated to lymph node metastasis from follicular thyroid carcinoma (FTC) is scarce and leads usually to a poor outcome.
Subjects and methods
We report a case of FTC with extensive vascular invasion into the right jugular vein and numerous lymph nodes. We reviewed clinical records of our patient and analysed clinical outcomes and thyroglobulin rate as well as imaging findings after radio-iodine therapy.
Results
Our patient was 60 years old female, who underwent total thyroidectomy. Histopathology exam revealed a FTC infiltrating the thyroid parenchyma and the thyroid capsule minimally with no search for malignant thyroid nodules which are supposed to be exceptional in this pattern. The patient was referred for RAI therapy. The initial post therapeutic whole body scan showed cervical uptake with high thyroglobulin levels (500 ng/ml). The second iodine scan revealed a left thoracic uptake corresponding to a costal metastasis, with persistent cervical uptake and elevated thyroglobulin. A hard dyspnea with facial and neck edema have marked the evolution of the disease, requiring a curative subcutaneous treatment with heparin and morphological exams. Cervical Tomography (CT) scan revealed a neoplasic thrombus infiltrating intraluminally the right jugular vein and numerous metastatic lymph nodes confirmed by magnetic resonance imaging (MRI). Highly challenging cooperative operation for thrombus and lymph nodes ablation has been practiced to avoid worsening clinical symptoms and mortality. Histological examination has confirmed the metastatic origin of the lesions.
Conclusion
Lymph node metastasis occur in less than 10% of patients with FTC but do not impact disease specific mortality.Vascular malignant infiltration from FTC is more frequent, and may uncommonly turn to potential life threatening clinical entity like for our patient. It requires specific management strategies with anticoagulation regimens and mostly targets the prevention of thrombus expansion as well as embolic phenomena. When feasible, thrombectomy should be seen as the best surgical procedure when an intraluminal extension of the disease is evident.
Article tools
My recent searches
My recently viewed abstracts
Authors
Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
© Bioscientifica 2024 |
Privacy policy |
Cookie settings
BiosciAbstracts
Bioscientifica Abstracts is the gateway to a series of products that provide a permanent, citable record of abstracts for biomedical and life science conferences.
Find out more