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Case Reports
. 2020 Jul-Sep;16(3):366-369.
doi: 10.4183/aeb.2020.366.

SYNCHRONOUS OCCURRENCE OF THREE DIFFERENT THYROID TUMORS

Y Darouassi  1 , A Aljalil  1 , A Azami  1 , M Elakhiri  1 , A Ennouali  1 , M A Hanine  1 , Y Chebraoui  1 , M Tayane  1 , M Mliha Touati  1 , I Rharrassi  1 , H Ammar  1
Affiliations
Case Reports

SYNCHRONOUS OCCURRENCE OF THREE DIFFERENT THYROID TUMORS

Y Darouassi et al. Acta Endocrinol (Buchar). 2020 Jul-Sep.

Abstract

Background: Thyroid nodules are common; however, the association of two or more different tumors in the thyroid gland is unusual. We present a first case with the association of three histological types of thryroid tumors. To the best of our knowledge, this association has not been reported in the literature before. We aim here to highlight the possible coexistence of many lesions in the thyroid gland and to discuss treatment options.

Case presentation: We report the case of a female patient who presented with a multinodular goiter. The final pathology after total thyroidectomy found the association of a multifocal papillary thyroid microcarcinoma arising within a Hurthle cells adenoma in a lobe and a noninvasive follicular thyroid neoplasm with papillary nuclear features in the other lobe. Due to the very low risk of recurrence, the patient was not treated with radioactive iodine.

Conclusions: Many controversies remain about the management of Hurthle cells tumors and many variants of papillary thyroid carcinoma. Although the management of our case did not change, more studies are necessary to analyze the evolution of patients with multiple thyroid neoplasms. When discussing therapeutic options, the advantages and disadvantages should be considered case by case based on disease staging.

Keywords: Hurthle cell tumor; NIFPT; papillary cells carcinoma; thyroid gland.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Figure 1.
Figure 1.
Hurthle cell thyroid tumor with regular nuclei (hematoxylin-eosin staining (HE), medium magnification).
Figure 2.
Figure 2.
Foci within the oncocytic adenoma with cytologic features of papillary carcinoma (HE staining at high magnification).
Figure 3.
Figure 3.
Immunohistochemical staining of foci of papillary carcinoma in the Hurthle cells adenoma by the anti-cytokeratin 19 antibody.
Figure 4.
Figure 4.
NIFTP with well-defined tumor proliferation of vesicular architecture.
Figure 5.
Figure 5.
NIFTP with enlarged, anisokaryotic, clarified, hunched and incisored nuclei (HE at high magnification).
See this image and copyright information in PMC

References

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