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Diffuse sclerosing variant of thyroid carcinoma presenting as Hashimoto thyroiditis: a case report
Anamarija Vukasović1, Sanja Kusacić Kuna, Karmen Trutin Ostović
1Department of Nuclear Medicine, Dubrava University Hospital, Zagreb, Croatia. anamarijavukasovic@gmail.com
Collegium Antropologicum
|February 13, 2013
Summary
This case report highlights a rare diffuse sclerosing variant of papillary thyroid carcinoma in a teenager. Early detection is crucial as it can mimic Hashimoto
Area of Science:
- Endocrinology
- Oncology
- Pathology
Background:
- Papillary thyroid carcinoma (PTC) is the most common thyroid malignancy.
- The diffuse sclerosing variant (DSV) of PTC is a rare subtype with distinct clinical and pathological features.
- Accurate diagnosis is essential for appropriate management and prognosis.
Observation:
- A 15-year-old female presented with painless thyroid swelling.
- Initial ultrasound revealed diffuse thyroid changes resembling Hashimoto thyroiditis, with a "snow-storm" appearance.
- Thyroid peroxidase antibodies (TPO-AT) were positive, further suggesting autoimmune thyroiditis.
- Fine needle-aspiration biopsy (FNAB) ultimately diagnosed diffuse sclerosing variant of papillary thyroid carcinoma.
Findings:
- Histopathological examination confirmed bilateral PTC, diffuse sclerosing variant, with lymph node metastases.
- The patient underwent total thyroidectomy and subsequent radioiodine therapy (1-131).
- Post-treatment, the patient shows no evidence of disease recurrence or metastasis.
Implications:
- The diffuse sclerosing variant of papillary thyroid carcinoma can present insidiously, mimicking benign thyroid conditions like Hashimoto thyroiditis.
- High index of suspicion and thorough diagnostic workup, including repeat FNAB, are vital for early diagnosis.
- Prompt treatment involving surgery, radioiodine ablation, and hormone replacement is effective in managing this rare thyroid cancer.
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