Abstract
Background:
Papillary thyroid microcarcinoma (PTMC) generally presents with an indolent disease course and good prognosis. However, some PTMCs show aggressive behavior, such as multiple-level metastasis at initial diagnosis, which indicates a high risk of locoregional recurrence and poor disease-free survival.
Method:
We present a case of a 39-year-old female first diagnosed at age of 18 with potentially malignant mass in the right lateral neck compartment
Results:
At first thyroid US and FNA malignancy was not proven. Due to clinical signs of malignant process operation was offered but the patient refused. No significant progression of the neck mass during the next 20 years was noticed. Later due to increasing compression symptoms, CT was performed. A large 8cm lymph node conglomerate laterally from the right carotid sheath was visualized.
Thyroid US showed multiple nodules TIRADS 5. In the biopsy from lateral neck mass, papillary carcinoma complexes were diagnosed. PET-CT showed no other pathological uptake, except in lateral neck lymph nodes. Total thyroidectomy and right-side central and lateral lymph node dissection was performed. Morphology revealed multifocal PTMC in the right thyroid lobe.
Metastases were found in all 6 lateral and in 13 out of 18 central neck compartment lymph nodes.
Diagnosis of multifocal papillary microcarcinoma T1a(m)N1bM0, Stage I was established. The patient received I131 therapy. At 6-month follow-up, no recurrence was found.
Conclusion:
Nevertheless, PTMCs in general are indolent tumors, they can be presented with
macrometastases. MDT approach facilitates promotion of patients' trust.
Papillary thyroid microcarcinoma (PTMC) generally presents with an indolent disease course and good prognosis. However, some PTMCs show aggressive behavior, such as multiple-level metastasis at initial diagnosis, which indicates a high risk of locoregional recurrence and poor disease-free survival.
Method:
We present a case of a 39-year-old female first diagnosed at age of 18 with potentially malignant mass in the right lateral neck compartment
Results:
At first thyroid US and FNA malignancy was not proven. Due to clinical signs of malignant process operation was offered but the patient refused. No significant progression of the neck mass during the next 20 years was noticed. Later due to increasing compression symptoms, CT was performed. A large 8cm lymph node conglomerate laterally from the right carotid sheath was visualized.
Thyroid US showed multiple nodules TIRADS 5. In the biopsy from lateral neck mass, papillary carcinoma complexes were diagnosed. PET-CT showed no other pathological uptake, except in lateral neck lymph nodes. Total thyroidectomy and right-side central and lateral lymph node dissection was performed. Morphology revealed multifocal PTMC in the right thyroid lobe.
Metastases were found in all 6 lateral and in 13 out of 18 central neck compartment lymph nodes.
Diagnosis of multifocal papillary microcarcinoma T1a(m)N1bM0, Stage I was established. The patient received I131 therapy. At 6-month follow-up, no recurrence was found.
Conclusion:
Nevertheless, PTMCs in general are indolent tumors, they can be presented with
macrometastases. MDT approach facilitates promotion of patients' trust.
| Original language | English |
|---|---|
| Pages | 71-71 |
| Number of pages | 1 |
| Publication status | Published - 2023 |
| Event | 10th Conference of European Society of Endocrine Surgeons: Consensus meeting on advanced endocrine malignancies - Mainz, Germany Duration: 18 May 2023 → 20 May 2023 Conference number: 10 https://eses2023.org/ |
Conference
| Conference | 10th Conference of European Society of Endocrine Surgeons |
|---|---|
| Country/Territory | Germany |
| City | Mainz |
| Period | 18/05/23 → 20/05/23 |
| Internet address |
Field of Science*
- 3.2 Clinical medicine
Publication Type*
- 3.4. Other publications in conference proceedings (including local)