Abstract
IntroductionPapillary thyroid carcinoma and medullary thyroid carcinoma are two different thyroid neoplasia. The simultaneous occurrence of medullary thyroid carcinoma and papillary thyroid carcinoma as a collison tumor with metastases from both lesions in the regional lymph nodes is a rare phenomenon.Case presentationA 32-year-old Iranian man presented with a fixed anterior neck mass. Ultrasonography revealed two separate thyroid nodules as well as a suspicious neck mass that appeared to be a metastatic lesion. The results of thyroid function tests were normal, but the preoperative calcitonin serum value was elevated. Our patient underwent a total thyroidectomy with neck exploration. Two separate and ill-defined solid lesions grossly in the right lobe were noticed. Histological and immunohistochemical studies of these lesions suggested the presence of medullary thyroid carcinoma and papillary thyroid carcinoma. The lymph nodes isolated from a neck dissection specimen showed metastases from both lesions.ConclusionsThe concomitant occurrence of papillary thyroid carcinoma and medullary thyroid carcinoma and the exact diagnosis of this uncommon event are important. The treatment strategy should be reconsidered in such cases, and genetic screening to exclude multiple endocrine neoplasia 2 syndromes should be performed. For papillary thyroid carcinoma, radioiodine therapy and thyroid-stimulating hormone suppressive therapy are performed. However, the treatment of medullary thyroid carcinoma is mostly radical surgery with no effective adjuvant therapy.
Highlights
Papillary thyroid carcinoma and medullary thyroid carcinoma are two different thyroid neoplasia
The treatment strategy should be reconsidered in such cases, and genetic screening to exclude multiple endocrine neoplasia 2 syndromes should be performed
Four lymph nodes isolated from the neck dissection specimen showed metastasis of medullary thyroid carcinoma (MTC), and one of them showed metastatic Papillary thyroid carcinoma (PTC)
Summary
The simultaneous occurrence of MTC and PTC presented as two distinct and well-defined tumor components. Overall, mixed MTC-PTC is a rare clinical entity and should be considered in the differential diagnosis of thyroid tumors, in patients with a family history of thyroid malignancy. Consent Written informed consent was obtained from the patient for publication of this case report and any accompanying images. Author details 1Department of Nuclear Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. Authors’ contributions NA participated in histology-related issues and literature review and drafted the manuscript. MSA contributed to patient treatment and revised respective sections in the manuscript. Both authors read and approved the final manuscript.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
