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. 2023 Apr 11;85(5):2155-2158.
doi: 10.1097/MS9.0000000000000648. eCollection 2023 May.

Primary thyroid tuberculosis mimicking papillary carcinoma of thyroid: a rare case report

Sabin Banmala  1 , Sarita K C  2 , Manita Raut  2 , Rajesh Poudel  1 , Sabin Karki  1 , Suman Maharjan  1
Affiliations

Primary thyroid tuberculosis mimicking papillary carcinoma of thyroid: a rare case report

Sabin Banmala et al. Ann Med Surg (Lond). .

Abstract

Primary thyroid tuberculosis is an extremely rare extrapulmonary involvement by the causative agent, Mycobacterium tuberculosis. Its rarity and resemblance to thyroid malignancy led to unnecessary aggressive operative interventions.

Case presentation: A 54-year-old female presented with recent onset dysphagia and foreign body sensation in the throat for 3 months, and anterior neck swelling since last 10 years.

Clinical findings and investigations: A single nodular firm anterior neck swelling was present which moves with deglutition. Thyroid function test was normal. Ultrasonography thyroid revealed TIRADS-3. Fine-needle aspiration cytology was suggestive of papillary carcinoma of thyroid.

Interventions and outcome: Total thyroidectomy with central compartment neck dissection was performed. Histopathology of the thyroid specimen revealed tubercular thyroiditis. Postoperatively, Mantoux test and interferon gamma radioassay were positive. Antitubercular therapy was given for total of 6 months.

Conclusions: With ultrasonography-guided fine-needle aspiration cytology, preoperative diagnosis of primary thyroid tuberculosis is quite challenging even in tuberculosis endemic countries. So, it should be considered one of the differential diagnoses despite negative relevant history and without clinical cervical lymph nodes involvement with cytology proven suspicious papillary thyroid cancer before proceeding for surgical intervention.

Keywords: Mycobacterium tuberculosis; case report; thyroid malignancy; thyroid tuberculosis; tubercular thyroiditis.

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Conflict of interest statement

The authors declare that they have no financial conflict of interest with regard to the content of this report.

Figures

Figure 1
Figure 1
Female with thyroid swelling.
Figure 2
Figure 2
AFB seen in surgically removed thyroid specimen (black arrow).
Figure 3
Figure 3
Histopathology examination of tubercular thyroiditis showing necrosis (black arrow).
See this image and copyright information in PMC

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