Endocrine Abstracts

Introduction: Angiosarcomas are aggressive malignant tumors but very rare especially when they are located in the thyroid, characterized histologically by their vascular differentiation and their polymorphic appearance.

Observation: We report the case of a 68-years-old female patient, from a mountainous region who has a history of cholecystectomy in 2018, she underwent a total thyroidectomy for a compressive goiter, the postoperative period was marked by an hypoparathyroidism which was substituted. The anatomopathological examination of the surgical specimen showed a thyroid localization of an angiosarcoma of 5 cm of large axis with extension to the fatty and muscular tissue around the thyroid. The CT scan which was performed two months after the surgery showed a left later tracheal formation measuring 9×5 cm suggesting a recurrence. Adjuvant radiotherapy was proposed to our patient.

Discussion: Angiosarcoma of the thyroid is a rare but very aggressive tumor. it affects more women than men with a sex ratio of 9/3 and an average age of 69 years. These tumors were initially described in the inhabitants of alpine regions where their frequency varies between 2 and 10% of all malignant thyroid tumors. This predilection for mountainous regions has been explained by the iodine deficiency leading to goiter, however, the existence of cases in non-mountainous regions without associated goiter suggests that there are other etiological factors not yet known. These tumors are most often revealed by a rapidly growing cervical mass that may be accompanied by signs of compression, as they can be revealed by metastases in particular pulmonary. Local recurrence and metastasis are frequent and early. The prognosis is poor and the average survival is 9 months.

Conclusion: Thyroid localization of angiosarcoma is exceptional but possible. The therapeutic difficulty is correlated to the frequency of recurrence and its metastatic nature.