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Benign calcified thyroid cyst with skin sinus formation.
Indranil Pal1, Subhabrata Sengupta, Balakrishnan Ramaswamy
1Department of Ear-Nose-Throat and Head and Neck Surgery, Sikkim Manipal Institute of Medical Sciences, Gangtok, Sikkim, India. thisisindranil@yahoo.co.in
The Laryngoscope
|November 3, 2007
Summary
This case study highlights a rare calcified thyroid cyst presenting as a discharging neck sinus. Histopathology confirmed a benign multinodular goiter with dystrophic calcification, despite initial suspicion of malignancy.
Area of Science:
- Endocrinology
- Surgical Pathology
- Oncology
Background:
- Thyroid nodules are common, but calcified cysts with draining sinuses are rare.
- Differentiating benign from malignant thyroid conditions is crucial for patient management.
Observation:
- A 75-year-old male presented with a 50-year history of thyroid swelling and a 1-year history of a discharging neck sinus with ulceration.
- Imaging revealed tracheal deviation and irregular calcification in the left thyroid lobe.
- Fine needle aspiration cytology (FNAC) was inconclusive for the left lobe due to hardness, but suggested adenomatous goiter for the right lobe.
Findings:
- Subtotal thyroidectomy was performed.
- Histopathology confirmed multinodular goiter with dystrophic calcification, not malignancy.
- The clinical presentation mimicked malignant transformation of a pre-existing adenomatoid goiter.
Implications:
- This case underscores the importance of histopathological examination for definitive diagnosis of complex thyroid presentations.
- Understanding dystrophic calcification in benign thyroid lesions is key to avoiding misdiagnosis.
- Rare presentations of thyroid disease require thorough investigation and differential diagnosis.
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