Thyroid paragangliomas are locally aggressive.

Area of Science:

• Endocrinology
• Surgical Oncology
• Pathology

Background:

• Thyroid paraganglioma (TP) is an exceptionally rare neoplasm.
• TP can be challenging to diagnose preoperatively and may be misdiagnosed.
• This study evaluates the clinical and pathological characteristics of three TP cases.

Observation:

• TP is rare, accounting for 0.04% of thyroidectomies over three decades.
• Patients presented with advanced local invasion (stridor, tracheal invasion, vascular compression, hemoptysis).
• Preoperative diagnosis was not suspected; fine-needle aspiration (FNA) was often inadequate.

Findings:

• TP commonly presents with compressive symptoms due to local invasion.
• Histopathology and immunohistochemistry (positive for S100, negative for cytokeratin, calcitonin, thyroglobulin) aid diagnosis.
• TP is locally aggressive, often requiring extensive resection, including adjacent structures like the trachea.

Implications:

• Despite its rarity and local aggressiveness, aggressive surgical resection of TP can achieve long disease-free intervals.
• TP does not typically cause catecholamine excess symptoms.
• Accurate diagnosis and surgical management are crucial for favorable outcomes.