Abdullah Ari M, Ali Rawa M, Salih Karzan M, Mohammed Karukh K, Kakamad Fahmi H, Salih Abdulwahid M
Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq; Sulaimani Teaching Hospital, Sulaimani, Kurdistan, Iraq.
Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq.
Int J Surg Case Rep. 2022 Apr;93:106888. doi: 10.1016/j.ijscr.2022.106888. Epub 2022 Mar 1.
The synchronous development of a medullary and papillary carcinoma as two different tumors has only been reported very rarely. The aim of the current report is to describe an extremely rare occurrence of medullary carcinoma, papillary microcarcinoma, and Hashimoto thyroiditis.
A 53-year-old man presented with a right-sided neck mass. Ultrasound showed a well-defined nodule in the right mid third with microcalcification and increased nodular vascularity associated with multiple right-sided cervical lymphadenopathy. The histopathological examination showed multifocal medullary carcinoma with incidental finding of unifocal papillary microcarcinoma conventional type on the left side. Additional pathology of Hashimoto thyroiditis with a small intra-thyroidal parathyroid gland in the left thyroid gland. The procedure went perfectly and the patient was discharged home without any difficulties.
Synchronous existence of these two neoplasms can occur in two forms: distinct medullary carcinoma and papillary carcinoma isolated by normal thyroid tissue, or mixed medullary and follicular-derived thyroid carcinoma, in which single or multiple lesions show morphology and immunoreactivity for both medullary carcinoma and follicular-derived carcinoma.
The synchronous coexistence of papillary microcarcinoma, medullary carcinoma, and Hashimoto's thyroiditis is an uncommon thyroid condition.
髓样癌和乳头状癌作为两种不同肿瘤同时发生的情况极为罕见。本报告旨在描述一种极为罕见的髓样癌、乳头状微小癌和桥本甲状腺炎同时出现的病例。
一名53岁男性因右侧颈部肿块就诊。超声显示右中三分之一处有一个边界清晰的结节,伴有微钙化,结节血管增多,右侧颈部多发淋巴结肿大。组织病理学检查显示多灶性髓样癌,左侧偶然发现单灶性传统型乳头状微小癌。另外还有桥本甲状腺炎的病理表现,左侧甲状腺内有一个小的甲状腺内甲状旁腺。手术过程顺利,患者顺利出院。
这两种肿瘤同时存在可表现为两种形式:由正常甲状腺组织分隔的明显的髓样癌和乳头状癌,或髓样和滤泡源性甲状腺癌混合,其中单个或多个病灶同时表现出髓样癌和滤泡源性癌的形态及免疫反应性。
乳头状微小癌、髓样癌和桥本甲状腺炎同时并存是一种罕见的甲状腺疾病。