Papillary and medullary thyroid carcinoma with a single hybrid lymph node: a case report with review of literature

Abstract

Synchronous medullary and papillary thyroid carcinoma (MTC-PTC) is rare, particularly with metastasis to the same lymph node. This study presents a unique case of synchronous metastatic MTC and PTC in a single lymph node. A 35-year-old male presented with a neck swelling, diagnosed with MTC-PTC. Imaging revealed thyroid nodules, and histopathological examination following thyroidectomy confirmed mixed MTC-PTC with lymph node metastasis. Literature reports similar cases in patients aged 24-64, often presenting with neck lumps. Management typically involves total thyroidectomy with lymph node dissection, yielding favorable outcomes. Treatment should follow guidelines based on disease stage. Due to its rarity, further research is needed to better understand and manage this condition.

Keywords: medullary thyroid carcinoma; mixed lymph node metastasis; papillary thyroid carcinoma; synchronous.

Figure 1

(A) Section from the thyroid tumor showing an area composed of dyscohesive plasmacytoid cells with salt-pepper chromatin and presence of eosinophilic material in between them representing amyloid material (dark arrow), while bellow it, separated by a fibrous band (green star), there is an area showing follicular epithelial cells, with nuclear features of papillary thyroid carcinoma (yellow arrow). Hematoxylin and eosin stain, 4 × 10. (B) Section from the lymph node reveal both tumor components mixed with each other, area showing papillary structures that covered by follicular epithelial cells with nuclear features of papillary thyroid carcinoma (dark arrows) with other area composed of solid nests of dyscohesive cells that representing the medullary thyroid carcinoma. Hematoxylin and eosin stain, 4 × 10.