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A thyroidectomy case with a surprising pathologic result: three different birds in one nest
Mehlika Isildak1, Duygu Yazgan Aksoy, Aysen Terzi
1Department of Internal Medicine, Section of Endocrinology and Metabolism, HaceHepe University, Ankara, Turkey.
The American Journal of the Medical Sciences
|February 16, 2006
Summary
This case highlights a rare instance of papillary thyroid microcarcinoma and Hurthle cell neoplasm coexisting with multinodular goiter. It underscores that multinodular goiter does not exclude malignancy risk, regardless of patient factors.
Area of Science:
- Endocrinology
- Oncology
- Pathology
Background:
- Thyroid neoplasms encompass a spectrum from indolent papillary carcinomas to aggressive anaplastic disease.
- Hurthle cell neoplasm is a recognized subtype associated with a poorer prognosis.
Observation:
- A 72-year-old female with multinodular goiter underwent surgery due to nodule size, despite benign fine needle aspiration biopsy results.
- Histopathology revealed concurrent papillary thyroid microcarcinoma in one lobe and Hurthle cell neoplasm in the other.
- The remaining thyroid tissue exhibited typical colloidal goiter.
Findings:
- The simultaneous presence of papillary thyroid microcarcinoma and Hurthle cell neoplasm within a multinodular goiter is uncommon.
- Multinodular goiter carries a malignancy risk comparable to solitary thyroid nodules.
Implications:
- Physician assessment and therapeutic approach for multinodular goiter should not be solely influenced by patient age, disease duration, or nodule count.
- This case emphasizes the importance of thorough histopathological evaluation in multinodular goiter management.