Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2010) 22 P846

ECE2010 Poster Presentations Thyroid (122 abstracts)

Limited therapeutically options in a case of invasive papillary thyroid carcinoma

Mara Carsote 1 , Raluca Trifanescu 1, , Corina Chirita 2 , Cristina Ene 2 , Dumitru Ioachim 2 , Dana Terzea 1, , Catalina Poiana 1, & Mihail Coculescu 1,

1Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; 2C. I. Parhon National Institute of Endocrinology, Bucharest, Romania; 3Babes Institute of Research and Development, Bucharest, Romania.

Introduction: Even the differentiated thyroid neoplasm have good prognostic, there are some particular cases that become very aggressive in short time, with poor management.

Aim: We report a female case diagnosed with invasive papillary thyroid carcinoma.

Case report: Seventy-three-year old female was diagnosed at age of 71 with a right lobe thyroid nodule (of almost 6 cm). At that moment the computed tomography (CT) of the cervical region revealed invasion into the scalen muscle and the hyoid bone, and multiple cervical lymph nodes of maxim 1 cm. The fine needle aspiration biopsy (FNAB) suggested very well differentiated papillary carcinoma. The patient consulted the general practitioner who did not recommend surgery. On admission, 2 years later, the thyroid function was normal but the patient had obstructive symptoms. She presented local invasion into the larynx, up to the base of the tongue of 11 cm, according to MRI and CT of the region. The common carotid artery was invaded of 2.5 cm. The FNAB aspects still revealed low aggressive profile with no anaplasic shift. Multidisciplinary consult was performed but the case was considered inoperable due the carotid artery invasion as revealed by angioMRI. Further tracheotomy will be necessary.

Conclusion: This is a rare case when the fine needle aspiration biopsy suggested a differentiated thyroid cancer, apparently with a good prognosis. Despite the cellular aspects, the histological profile would be a useful tool but the case was considered inoperable due to the aggressive local invasion, especially into the carotid artery. Eventually, palliative surgery will be necessary.

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