Aldeligan Saleh Husam, AlQahtani Abdulaziz S, Aljunaydil Abdullah, Alzahrani Nashwa, Alakeel Fadi, Althobaiti Budur T, Bokhari Areej
College of Medicine, King Saud University, PO Box 2925, Riyadh 11461, Saudi Arabia.
Department of Surgery, King Saud University Medical City, PO Box 2925, Riyadh 11461, Saudi Arabia.
J Surg Case Rep. 2025 Jun 10;2025(6):rjaf398. doi: 10.1093/jscr/rjaf398. eCollection 2025 Jun.
The synchronous occurrence of Hodgkin lymphoma (HL) and papillary thyroid carcinoma (PTC) in a young adult without prior radiation exposure is exceedingly rare. The diagnostic challenge arises in differentiating between lymph node metastases from PTC and HL involvement. The absence of clear protocols for managing such cases further complicates treatment. We report a 28-year-old male with a body mass index (BMI) of 44.3 kg/m who presented with progressive neck swelling over 2 years. Initial investigations, including fine-needle aspiration (FNA) and imaging, revealed concurrent diagnoses of PTC and HL. The patient underwent total thyroidectomy with central compartment lymph node dissection, followed by radioactive iodine (RAI) ablation. Despite initial disease control, he later developed recurrent HL, confirmed via histopathological and immunohistochemical analysis. The coexistence of HL and PTC in a single patient raises questions regarding shared risk factors, though no established causal link exists. The rarity of this presentation highlights the necessity of a multidisciplinary approach for accurate diagnosis and treatment. Coordinating therapies such as RAI for PTC and chemotherapy for HL is critical to optimizing patient outcomes while minimizing adverse effects. This case underscores the importance of early recognition and tailored management of synchronous malignancies. The lack of established guidelines necessitates documentation of such cases to inform future clinical practice. Further research into potential risk factors, including genetic predisposition and environmental influences, is warranted.
在没有既往辐射暴露史的年轻成年人中，霍奇金淋巴瘤（HL）和甲状腺乳头状癌（PTC）同时发生极为罕见。诊断难题在于区分PTC的淋巴结转移和HL累及。缺乏针对此类病例的明确管理方案使治疗进一步复杂化。我们报告一名28岁男性，体重指数（BMI）为44.3kg/m²，2年来颈部逐渐肿胀。包括细针穿刺活检（FNA）和影像学检查在内的初步检查显示同时诊断为PTC和HL。患者接受了全甲状腺切除术及中央区淋巴结清扫，随后进行放射性碘（RAI）消融。尽管最初疾病得到控制，但他后来出现HL复发，经组织病理学和免疫组织化学分析确诊。单一患者中HL和PTC共存引发了关于共同危险因素的疑问，尽管尚无既定的因果联系。这种表现的罕见性凸显了采用多学科方法进行准确诊断和治疗的必要性。协调针对PTC的RAI治疗和针对HL的化疗等疗法对于优化患者预后同时最小化不良反应至关重要。该病例强调了早期识别和针对性管理同步性恶性肿瘤的重要性。缺乏既定指南使得记录此类病例以指导未来临床实践成为必要。有必要对包括遗传易感性和环境影响在内的潜在危险因素进行进一步研究。
