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Case Reports
. 2017 Jun 2:2017:bcr2017219747.
doi: 10.1136/bcr-2017-219747.

Insular carcinoma arising on a background of follicular carcinoma, thyrolipomatosis and amyloid goitre

Tze Ling Loh  1 , Sergios Latis  1 , Rohana Bibi Ali  1 , Hemi Patel  1
Affiliations
Case Reports

Insular carcinoma arising on a background of follicular carcinoma, thyrolipomatosis and amyloid goitre

Tze Ling Loh et al. BMJ Case Rep. .

Abstract

A 67-year-old man was referred with a history of a right-sided neck lump and dysphonia, secondary to a lesion in the thyroid gland. After undergoing a total thyroidectomy, he was found to have an exceedingly rare combination of follicular carcinoma, insular carcinoma, thyrolipomatosis and an amyloid goitre in his thyroid gland. He subsequently underwent further radioactive iodine ablation and has been in remission. He was also later incidentally diagnosed with systemic amyloidosis, which explained the amyloid deposition in his thyroid gland.

Keywords: Endocrine cancer; Head and neck cancer; Head and neck surgery; Pathology; Thyroid disease.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Coronal section of the patient’s neck CT scan, demonstrating the large fatty goitre and a solid lesion in the right lobe of the thyroid.
Figure 2
Figure 2
Insular carcinoma completely surrounded by follicular carcinoma.
Figure 3
Figure 3
Close-up of insular carcinoma, showing high mitotic activity and an insular growth pattern.
Figure 4
Figure 4
Close-up of both insular (bottom) and follicular (top) carcinomas.
Figure 5
Figure 5
H+E stained section of the thyroid parenchyma not involved by cancer. Diffuse adipose infiltration of the parenchyma is seen. The yellow arrow shows amyloid protein deposition.
See this image and copyright information in PMC

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