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Thyroid Warthin-Like Cancer Concurrent With Multiple Sclerosis: A Case Report.

Lucia Stella Curto¹, Rita Gervasi², Valeria Zuccala³

¹Unit of Clinical Surgery, Department of Medical and Surgical Sciences, Magna Graecia University Medical School, Catanzaro, Italy.

Journal of Medical Cases

|August 26, 2021

Summary

Warthin-like papillary thyroid cancer (WL-PTC) is rare and hard to diagnose preoperatively. This case suggests systemic autoimmune diseases like multiple sclerosis may influence WL-PTC development, even without Hashimoto thyroiditis.

Keywords:

Autoimmune disease Hashimoto thyroiditis Multiple sclerosis Thyroid Warthin-like carcinoma

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Area of Science:

Endocrinology
Oncology
Immunology

Background:

Warthin-like papillary thyroid cancer (WL-PTC) is a rare thyroid malignancy.
WL-PTC is often associated with Hashimoto thyroiditis (HT), which typically indicates a better prognosis.
Distinguishing WL-PTC from classic papillary thyroid cancer preoperatively is challenging.

Observation:

A 43-year-old female with a history of multiple sclerosis (MS) presented with a solitary thyroid nodule suspicious for cancer.
Thyroid hormone levels and thyroid antibodies were normal.
Histological examination confirmed WL-PTC in the absence of HT.

Findings:

The case highlights a rare instance of WL-PTC in a patient with a systemic autoimmune disease (MS) but without evidence of HT.
This finding challenges the assumption that local autoimmune responses like HT are the sole contributors to WL-PTC pathogenesis.
The study suggests a potential role for systemic autoimmune conditions in the development of WL-PTC.

Implications:

Further research is needed to elucidate the complex interplay between systemic autoimmunity and thyroid cancer development.
Understanding these mechanisms could lead to improved diagnostic strategies and risk stratification for WL-PTC.
This case broadens the perspective on potential etiological factors in rare thyroid cancers.