Papillary thyroid carcinoma

Case contributed by Dr Fateme Hosseinabadi

Presentation

50 years old man with palpaple cervical mass

Patient Data

Age: 50 years
Gender: Male
MRI

The whole right lobe and isthmus of thyroid gland have altered signal in keeping with diffuse infiltrative tumoral involvement. This is contigious with soft tissue extending into the midline subcutaneous region and right strap muscles. right anterolateral aspect of trachea show abnormal signal intensity, and right aspect of thyroid cartilage showes abnormal signal intensity and enhancement. There is an enhancing lymph node with isosignal intensity with thyroidal mass at left carotid space (metastasis). multiple bilateral cervical and right paratracheal lymph nodes are noted too. Abnormal rim enhancing lesion at superior segment of RUL is seen.

Pathology

Large cold nodule on the right lobe and isthmus.

Left thyroid lobe nodule biopsy showed PTC.

Case Discussion

Papillary thyroid cacinoma is the most common thyroid cancer (80%), and most commonly PTCs are totally asymptomatic. cervical metastasis (lymph node spread) are present in 50% of small PTCs and in 75% of the larger PTCs.The presence of lymph node metastasis in the neck has a more frequent recurrence rate but no higher mortality rate. PTCs that invade the adjacent tissues next to the thyroid gland have worse prognosis due to high local recurrence rate. Iodinated contrast materials used in CT scans, interferes with radioiodine scans. The iodine used for CT scan will be elaminated from the body in approximately two months.

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Case information

rID: 65710
Published: 20th Jan 2019
Last edited: 22nd Jan 2019
System: Head & Neck
Inclusion in quiz mode: Included
Institution: Zahedan medical university

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