Metastatic Papillary Thyroid Carcinoma Arising in a Neglected Goiter: A Case Report
Autor: | Alan Basil Peter, Mohd Zulhilmie Mohd Nasir, Khasnur Abd Malek, Awla Mohd Azraai |
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Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
medicine.medical_specialty
endocrine system malignant transformation Goiter endocrine system diseases delayed surgical treatment Papillary thyroid cancer lcsh:Medicine 030209 endocrinology & metabolism Palpation Thyroid carcinoma diffuse goiter 03 medical and health sciences 0302 clinical medicine medicine Carcinoma 030212 general & internal medicine Thyroid cancer nodular goiter medicine.diagnostic_test business.industry Thyroid lcsh:R Nodule (medicine) General Medicine medicine.disease medicine.anatomical_structure Radiology medicine.symptom business |
Zdroj: | Open Access Macedonian Journal of Medical Sciences, Vol 8, Iss C (2020) Open Access Macedonian Journal of Medical Sciences; Vol. 8 No. C (2020): C-Case Reports; 55-59 |
ISSN: | 1857-9655 |
Popis: | BACKGROUND: Periodical clinical surveillance for early thyroid cancer detection among patients with diffuse goiter is a common scenario managed in the primary care setting. However, clinical palpation alone is neither sensitive nor specific in detecting the presence of nodules within a goiter. Hence, further investigation with ultrasound is key to effective surveillance for early detection of thyroid cancer. CASE REPORT: We present a case of a stable diffuse goiter in a 51-year-old woman diagnosed 30 years ago who refused further imaging investigation. Based solely on clinical palpation, the presence of nodules within the goiter was missed. This resulted in transformation into papillary thyroid carcinoma with lung metastases. She presented with progressive hoarseness of voice and cough for 3 months. An ultrasound of the thyroid gland revealed a large heterogeneous nodule in the left lower pole with coarse calcification and internal vascularity. Further imaging with contrast-enhanced computed tomography of the neck and thorax revealed an enhancing nodule in the left thyroid lobe which extends inferiorly to the left retroclavicular region which compresses the trachea causing narrowing of its lumen at T1 and T2 vertebral levels. There were multiple lung nodules in both lungs suggestive of metastases. CONCLUSION: A total thyroidectomy followed by radioactive iodine thyroid ablation therapy was performed. The histopathological examination revealed the surgical specimen to be papillary thyroid carcinoma. |
Databáze: | OpenAIRE |
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