ISSN: 1301-2193 E-ISSN: 1308-9846
  • Turkish Journal of
    Endocrinology and Metabolism
CASE REPORT

Coexistence of Papillary and Medullary Thyroid Carcinoma: A Rare Entity
Papiller ve Medüller Tiroid Kanseri Birlikteliği: Nadir Bir Olgu Sunumu
Received Date : 26 Oct 2019
Accepted Date : 25 Apr 2020
Available Online : 08 May 2020
Doi: 10.25179/tjem.2019-72499 - Makale Dili: EN
Turk J Endocrinol Metab. 2020;24:168-172
Bu makale, CC BY-NC-SA altında lisanslanmış açık erişim bir makaledir.
ABSTRACT
The coexistence of different types of thyroid carcinomas is rather unusual. It has been considered coincidental and linked to the growing incidence of papillary thyroid carcinoma (PTC). This paper presents a case of multifocal PTC and coexistent medullary thyroid carcinoma (MTC) distinct from each other, along with PTC lymph node metastasis. The 44- year-old female patient underwent subtotal thyroidectomy with a pre-operative diagnosis of multinodular goiter. Histological reports revealed PTC in the right lobe and PTC beside a tumoral area morphologically suspicious for MTC in the left thyroid lobe. Immunohistochemistry confirmed the diagnosis of MTC. Post-operative ultrasound and subsequent fine needle aspiration biopsy revealed lymph node metastases of PTC in the right anterior cervical area. Complementary thyroidectomy, central neck dissection, and right modified neck dissection were carried out with subsequent I-131 ablation therapy. In conclusion, the biological behaviors and prognoses of MTC and PTC are different. Therefore, the entity demands a different clinical approach in treatment and follow-up.
ÖZET
Farklı tipteki tiroid karsinomlarının birlikteliği oldukça nadirdir. Bu durum tesadüfi olarak kabul edilmekte olup, giderek artan papiller tiroid kanseri [papillary thyroid carcinoma (PTC)] insidansı ile ilişkilendirilmektedir. Bu yazıda, birbirinden normal tiroid dokusu ile net olarak ayrılmış medüller tiroid kanseri [medullary thyroid carcinoma (MTC)] yanı sıra multifokal PTC ve PTC lenf metastazı tespit ettiğimiz olgumuzu sunuyoruz. Kliniğimize başvuran 44 yaşındaki kadın hasta, multinodüler guatr tanısı ile subtotal tiroidektomi operasyonu geçirmiş. Histolojik incelemede sağ tiroid lobunda PTC, sol tiroid lobunda ise PTC’nin yanı sıra MTC için morfolojik olarak şüpheli tümör bölgesi rapor edilmiş. MTC şüphesi immünohistokimyasal olarak pozitif kalsitonin ekspresyonu ile doğrulandı. Postoperatif ultrasonografi ve takiben ince iğne aspirasyon biyopsisi ile sağ ön servikal lenf nodunda PTC metastazı tespit edildi. Hastaya tamamlayıcı tiroidektomi, santral boyun diseksiyonu ve sağ modifiye boyun diseksiyonu sonrası I-131 ablasyon tedavisi uygulandı. Sonuç olarak, bu iki kanserin biyolojik özellikleri ve prognozlarının farklı olması bu tip olgularda tedavi ve takipte farklı klinik yaklaşım gerektirir.
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