We report the case of a 55 years old female patient with parallel appearance of mucoepidermoid carcinoma and papillary thyroid carcinoma. She had autoimmune adrenal insufficiency and a pulmonary adenocarcinoma cured by lobectomy and external irradiation six years before. She had been referred to our department because of a rapidly growing thyroid nodule. Aspiration cytology suspected papillary tumor and a tumor of non-thyroid origin as well. Thyroidectomy and bilateral neck lymph-node dissection were performed. Histopathology and immunhistochemistry revealed a TG+ and CEA- follicular variant of papillary carcinoma in the right lobe, mixed with a TG- CEA+ mucoepidermoid carcinoma giving bilateral lymph node metastases. A left side papillary microcarcinoma was also found.
Less than 40 cases of thyroid mucoepidermoid cancer were reported so far in a few cases combined with other types of thyroid cancer. The ultimobranchial apparatus or follicular origin is disputed. We assume that the anamnestic external irradiation of the chest and neck region 6 years before might have played a role in the pathogenesis of this rare combination of malignancies.
01 - 05 Apr 2006
European Society of Endocrinology