Metastatic Papillary Thyroid Carcinoma

Authors

  • Cody Bahavar Oklahoma State University Center for Health Sciences College of Osteopathic Medicine (OSU-COM)
  • Yoon Cho Oklahoma State University Center for Health Sciences
  • Jeff Lee Oklahoma State University Center for Health Sciences
  • Donald von Borstel Oklahoma State University Center for Health Sciences

Keywords:

Papillary, Thyroid Cancer, Diffuse Sclerosing Variant

Abstract

Papillary thyroid cancer has the fastest increasing incidence of any thyroid malignancy and accounts for the majority of thyroid neoplasms (75-85%). It is also the most common type of thyroid cancer to develop from radiation exposure1. Papillary thyroid cancer typically occurs in caucasions and has a female predilection (3:1 ratio), with a peak age of incidence between 25-50 years-old. It commonly presents as a painless neck mass. While no specific laboratory tests exist for diagnosis, elevation in thyroxine, triiodothyronine, or TSH can be seen. Radiology plays a crucial role in the diagnosis of papillary thyroid cancer, with ultrasound being one of the initial steps in the workup. Radioiodine (I-131) nuclear medicine studies can be used to check for distant metastases and ablate thyroid cancer. Thyroid lobectomy is the main treatment, with total thyroidectomy being reserved for higher risk tumors. We report an unusual clinical presentation of the diffuse sclerosing variant of papillary thyroid cancer in a 16-year-old male, who presented with a painless neck mass that had been growing over the past year. The patient subsequently received a total thyroidectomy and radioiodine treatment.

Author Biographies

Cody Bahavar, Oklahoma State University Center for Health Sciences College of Osteopathic Medicine (OSU-COM)

4th year Medical Student

Yoon Cho, Oklahoma State University Center for Health Sciences

Diagnostic Radiology Resident PGY 3

Jeff Lee, Oklahoma State University Center for Health Sciences

Diagnostic Radiology Resident in Body Fellowship

Donald von Borstel, Oklahoma State University Center for Health Sciences

Diagnostic Radiology Attending- MSK fellowship trained

References

References

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Giannini R, Ugolini C, Lupi C, et al. The heterogeneous distribution of BRAF mutation supports the independent clonal origin of distinct tumor foci in multifocal papillary thyroid carcinoma. J Clin Endocrinol Metab. 2007;92(9):3511-3516.

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Cerilli LA, Mills SE, Rumpel CA, Dudley TH, Moskaluk CA. Interpretation of RET immunostaining in follicular lesions of the thyroid. Am J Clin Pathol. 2002;118(2):186-193.

Tessler FN, Middleton WD, Grant EG, et al. ACR Thyroid Imaging, Reporting and Data System (TI-RADS): White Paper of the ACR TI-RADS Committee. Journal of the American College of Radiology. 2017;14(5):587-595. doi:10.1016/j.jacr.2017.01.046

Kim HS, Han B-K, Shin JH, et al. Papillary thyroid carcinoma of a diffuse sclerosing variant: ultrasonographic monitoring from a normal thyroid gland to mass formation. Korean J Radiol. 2010;11(5):579-582.

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Published

2019-11-08

Issue

Vol. 3 No. 3 (2019)

Section

Medical

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