Thyroid hemiagenesis associated with Hurthle cell carcinoma: A case report
| Autor: | Agnes Stephanie Harahap, Kevin Varian Marcevianto, Sani Hadiyan Rasyid, Diani Kartini, Maria Fransisca Ham, Sonar Soni Panigoro |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
endocrine system diseases Thyroid hemiagenesis Cost effectiveness Case Report Malignancy Neck exploration surgery Pathology Result Biopsy medicine TH thyroid hemiagenesis medicine.diagnostic_test business.industry Thyroid USG ultrasonography CT Computed Tomography medicine.disease Lobe medicine.anatomical_structure Fine-needle aspiration Surgery Radiology Hurthle cell carcinoma business Calcification FNAB fine needle aspiration biopsy |
| Zdroj: | International Journal of Surgery Case Reports |
| ISSN: | 2210-2612 |
| Popis: | Introduction and importance Thyroid hemiagenesis (TH) is a rare congenital anomaly where one lobe fails to develop, especially more frequently occurs on the left lobe. The exact mechanisms for thyroid morphogenesis remain unclear. In this paper, we report a rare case of right lobe TH associated with Hurthle cell carcinoma. Case presentation A 59 years old woman was admitted with a neck lump increasing in size in the last 20 years. There were no symptoms of hyperthyroidism and hypothyroidism. There was a palpable, painless 5 cm mass in the middle of the neck. Initial thyroid ultrasonography (USG) revealed an enlarged left lobe, with hypoechoic lesion with cystic component and calcification (TIRADS 4). However, the right lobe was non-visualized. Fine needle aspiration biopsy result tendency was a malignancy. Hence, isthmolobectomy was conducted. Pathology result was Hurthle cell carcinoma. On the ninth month, USG revealed fibrotic tissue in the right thyroid bed and bilateral lymphadenopathy. Due to discrepancy, the patient was planned for a neck exploration surgery and a right lobe incision. Intraoperatively, the right thyroid was absent. Intraoperative USG also confirmed no right thyroid lobe. Discussion Thyroid hemiagenesis can be visualized by using USG due to its practicality and cost effectiveness reasons. Follow up evaluations consisted of systematic monitoring of thyroid morphology and hormonal functions should follow the diagnosis of TH. Neck exploration surgery might need to be performed to clarify any discrepancy and confirm the diagnosis. Conclusion TH can be recognized through supporting examination; however, discrepancy may occur. Highlights • History taking and physical examination is mandatory yet might not adequate to diagnose hemiagenesis accompanying thyroid diseases. • Ultrasonography is easily performed, cost effective, and without any radiation exposure to identify thyroid hemiagenesis • If discrepancy occur in ultrasonography examination, neck exploration surgery can clarify and confirm the diagnosis. |
| Databáze: | OpenAIRE |
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