Morales CGM, Tapia ÁLL, González JF, Zárate OA, Díaz VD

Language: Spanish
References: 12
Page: 178-182
PDF size: 427.63 Kb.

ABSTRACT

Although carcinoma of thyroid gland is a common entity, the simultaneous presentation of papillary and medullary thyroid cancer is rare in the same patient. The cause of this unusual association is unknown, but there are several theories about the synchronous presentation of both carcinomas of different histological and embriologycal origin. There are less than 30 reports in the English medical literature of concurrent occurrence of both papillary and medullary thyroid cancer in the same thyroid gland, for this reason the diagnosis and treatment is controversial. We described the case of a 70-year-old man without family history of endocrine disorders or outstanding medical records; with a right cervical mass of 6 x 5 cm of slowly progressive growth for five months. The ultrasonography (USG) showed a hypoechoic cervical image consistent in a level IV lymph node and thyroid gland with normal characteristics. A single fine-needle aspiration biopsy of the right lobe nodule revealed the diagnosis of papillary thyroid cancer. Total thyroidectomy plus right modified radical neck dissection and central compartment lymph node neck dissection (level VI) were performed. The pathology results reported medullary thyroid carcinoma of 2 mm in the right lobe, papillary microcarcinoma with follicular differentiation in the right lobe and mixed lymph node metastasis, with perithyroid infiltration. This is the second case reported in Latin America of simultaneous papillary medullary thyroid cancer, beside this case had atypical presentation with a cervical mixed lymph node metastasis without growth of thyroid gland.

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