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Pyramidal lobe-dominant papillary thyroid carcinoma-A rare entity with important clinical implications
Henrique Messias1,2, Maria Luísa Sequeira1, Ricardo Nogueira1
1Head and Neck Surgery Department Portuguese Institute of Oncology Francisco Gentil Lisbon Portugal.
Clinical Case Reports
|May 19, 2023
Summary
Papillary thyroid carcinoma (PTC) in the rare pyramidal lobe presents unique challenges. Complete excision during thyroidectomy is crucial for effective treatment and patient follow-up.
Area of Science:
- Endocrinology
- Surgical Oncology
- Pathology
Background:
- Papillary thyroid carcinoma (PTC) is the most common thyroid malignancy.
- PTC located in the pyramidal lobe is exceptionally rare, leading to limited understanding of its clinical and pathological characteristics.
Observation:
- A case of PTC in the pyramidal lobe of a 77-year-old woman is presented.
- The patient underwent en bloc total thyroidectomy with excision of the pyramidal lobe, hyoid bone, and cervical lymph nodes.
Findings:
- Literature review indicates PTC in the pyramidal lobe often presents with adverse prognostic factors such as extrathyroidal extension, advanced T stage, and lymph node metastasis.
- A proposed classification, Upper Neck Papillary Thyroid Cancer (UPTC), includes these tumors, Delphi ganglion metastases, and thyroglossal duct cyst carcinomas.
Implications:
- The classification of UPTC may necessitate specific surgical approaches like orthotopic thyroidectomy.
- Complete pyramidal lobe excision during thyroidectomy could impact radioactive iodine therapy efficacy and patient surveillance strategies.
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