A Rare Case of Multifocal Papillary Thyroid Cancer in Bilateral Thyroid Cysts

Case Reports in Medicine
Anupama Roy ChowdhuryChoon Chieh Tan

Abstract

Papillary thyroid cancer (PTC) can present as a thyroid cyst. In its more aggressive form, PTC may be multifocal in nature and is associated with a poorer prognosis. In patients whom PTC is diagnosed incidentally after a diagnostic lobectomy, the decision whether to offer completion thyroidectomy is sometimes challenging to make if such patients fall in the 'low-to-intermediate' risk category. We present a case of a 55-year-old lady who had a predominantly cystic left thyroid nodule with no suspicious features on ultrasound as well as 2 subcentimetre simple right-sided cysts. She subsequently underwent left hemithyroidectomy, and this reported a T2 PTC in the thyroid cyst. This was followed by completion thyroidectomy which yielded the surprising finding of PTC in the two tiny right sided cysts. This case highlights the need for vigilance in managing patients with thyroid cysts even though thyroid ultrasound scan did not reveal any overt suspicious features.

References

Jun 24, 2005·ANZ Journal of Surgery·Kyung Un ChoiYong Gi Kim
Apr 10, 2009·Thyroid : Official Journal of the American Thyroid Association·Mi-Jung LeeMin Jung Kim
Jun 10, 2010·Journal of Clinical Ultrasound : JCU·Tara L HenrichsenIan D Hay
May 20, 2011·Annals of Surgical Oncology·Ji Soo ChoiEun-Kyung Kim
Aug 1, 2012·Acta Cytologica·Massimo BongiovanniZubair W Baloch
Jul 15, 2015·Thyroid : Official Journal of the American Thyroid Association·Ayham Al AfifRobert D Hart
Jan 9, 2016·Tumour Biology : the Journal of the International Society for Oncodevelopmental Biology and Medicine·Ning QuDao-Zhe Lin
Jul 15, 2016·World Journal of Surgery·Andreas KiriakopoulosDimitrios Linos

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