Curto Lucia Stella, Gervasi Rita, Zuccala Valeria, Innaro Nadia
Unit of Clinical Surgery, Department of Medical and Surgical Sciences, Magna Graecia University Medical School, Catanzaro, Italy.
Unit of Endocrine Surgery, A.O.U. Mater Domini, Catanzaro, Italy.
J Med Cases. 2021 Feb;12(2):71-73. doi: 10.14740/jmc3625. Epub 2020 Dec 30.
Warthin like-papillary thyroid cancer (WL-PTC) is a rare malignancy; it is difficult to distinguish preoperatively a WLPTC from a classic PTC. Often it is associated with Hashimoto thyroiditis (HT) that determines a better prognosis with a very low probability of recurrence. The case concerns a 43-year-old female with a single thyroid nodule suspected for cancer; and she had multiple sclerosis (MS) from the age of 19. Thyroid hormone levels were normal such as thyroid antibodies. Total thyroidectomy with lymphadenectomy of central compartment was performed. Histological examination revealed a Warthin like-PTC without Hashimoto thyroiditis. The mechanisms involved in pathogenesis of thyroid cancer in patients with autoimmune disease are not completely clear. We hypothesized that not only a local autoimmune response, such as HT, could contribute to the determination of this type of cancer but also a systemic autoimmune disease such as MS.
沃辛样乳头状甲状腺癌(WL-PTC)是一种罕见的恶性肿瘤;术前很难将WLPTC与经典PTC区分开来。它常与桥本甲状腺炎(HT)相关,HT可带来较好的预后,复发概率极低。该病例为一名43岁女性,有一个疑似癌症的甲状腺结节;她从19岁起患有多发性硬化症(MS)。甲状腺激素水平及甲状腺抗体均正常。实施了全甲状腺切除术及中央区淋巴结清扫术。组织学检查显示为无桥本甲状腺炎的沃辛样PTC。自身免疫性疾病患者甲状腺癌发病机制尚不完全清楚。我们推测,不仅局部自身免疫反应如HT可能促成此类癌症的发生,全身性自身免疫性疾病如MS也可能如此。