Endocrine Abstracts

Introduction: Association of Thyroid tuberculosis with thyroid cancer is a very rare entity. To the best of our knowledge, only six cases of thyroid TB and papillary thyroid cancer have been reported in the literature. The purpose of our work is to present the diagnostic and therapeutic modalities of this association.

Methods: Retroceptive study conducted on 4 patients followed and treated for papillary thyroid carcinoma associated with thyroid tuberculosis between 2019-2023.

Results: All our patients were women. The average age was 50 years. They all consulted for anterior neck swelling. History of diabetes and dysthyroidism in the family were noted in 1 case. There were none of the common TB symptoms such as low fever, fatigue, night sweats, emaciation or loss of appetite. None of the 4 patients had any history of pulmonary or extrapulmonaryTB. A clinical examination revealed multinodular goiter in 3 cases. There was no palpable lymphadenopathy in the neck. Thyroid function tests showed an euthyroidism state in all cases. Thyroid B-mode ultrasonography revealed a multinodular goiter in 3 cases eutirads IV, and a single nodule located in the left thyroid lobe in 1 case Eutirads IV. The chest X-ray was normal in all cases. A total thyroidectomy was performed in one time associated with central neck dissection. The intraoperative histological evaluation revealed papillary cancer. The final diagnosis was established by definitive histopathological examination. The histopathological examination of the dissected cervical lymph nodes showed the absence of TB, and metastasis. There were no post-operative complications. RadioIodine therapy and quadritherapy antituberculosis was prescribed in all cases. During the subsequent regular follow-up examinations there were no signs of disease recurrence.

Conclusion: Association of tuberculosis with thyroid papillary carcinoma is a very rare and implicated the possible role of mycobacterial infections in the tumorigenesis of PTC. Diagnosis of this association requires histological examination, which is usually made postoperatively. Further accumulation of cases and experience in the future would improve the diagnosis and treatment strategies of this entity.