VANISHING PAPILLARY THYROID CARCINOMA: MORPHOLOGICAL CHANGES AFTER FINE-NEEDLE ASPIRATION

Area of Science:

• Endocrinology
• Surgical Pathology
• Oncology

Background:

• Fine-needle aspiration (FNA) is a standard diagnostic procedure for thyroid nodules.
• Post-procedural morphological changes in thyroid tissue are uncommon but documented.
• These changes can impact subsequent diagnostic interpretations.

Observation:

• A 69-year-old male presented with a neck mass, leading to ultrasound-guided FNA of a suspicious thyroid nodule.
• Cytology revealed papillary thyroid cancer with significantly elevated thyroglobulin levels.
• Post-near total thyroidectomy, histopathology showed complete tumor infarction.

Findings:

• The initial FNA diagnosis of papillary thyroid cancer was complicated by post-procedural infarction.
• Histopathology confirmed complete necrosis of the tumor, with no viable cancer cells detected.
• The patient was considered cured without requiring radioactive iodine therapy.

Implications:

• Tissue infarction following thyroid FNA is a rare event (<2%), necessitating careful diagnostic review.
• Confirmation of diagnosis through histopathology is crucial to avoid misinterpretation of FNA findings.
• Thorough evaluation for capsular or extrathyroidal invasion is vital to prevent diagnostic errors.