Endocrine Abstracts

Introduction: Epstein-Barr virus (EBV) is a well-known human tumor virus with a very high prevalence in the population, this virus is associated with epithelial and lymphoid malignancies, including lymphoepithelioma carcinoma of thyroid. This subtype of thyroid carcinoma is characterized by histologic features similar to those of undifferentiated carcinoma of the thyroid.

Case Report: A 17-year-old male patient, his medical and family histories were non-specific. the physical examination found a large cervical swelling painful on palpation. The neck ultrasonography was performed revealed a left thyroid nodule of 46*26mm classified Tirads5 accompanied by three enlarged neck lymph nodes in the left level II and level III regions. Thyroid functional tests, calcitonin, and thyroid antibodies were within normal limits. A total thyroidectomy was scheduled for the patient ans bilateral neck lymph node dissection. The histologic slides of the thyroid tumor revealed EBV-associated lymphoepithelioma thyroid carcinoma with gonglion metastases. he subsequently benefited from chemotherapy and radiotherapy. and was put on Levothyroxine suppression therapy.

Discussion: EBV has been revealed to be associated with the development of many cancers, such as gastric cancer, nasopharyngeal carcinoma, and Hodgkin’s lymphoma. However, the relationship between thyroid tumorigeneses and EBV has not been fully elucidated with conflicting results. The preliminary investigation of EBV in thyroid lymphoma was inspired by EBV persistently infecting B lymphocytes, it can also infect T lymphocytes, myocytes, and epithelial cells, Once EBV infects a host cell, it starts to induce a lytic or latent infection with diverse genes expressed. These genes collaborate to induce tumorigenesis by causing systematic inflammation, suppressing the antitumoral immune system, and preventing anoikis The Chronic inflammation induced by EBV infection may play a significant role in the progression of lymphoepithelioma carcinoma of thyroid.

Conclusion: Lymphoepithelioma-like carcinoma is a rare entity among thyroid tumors, We reported a patient with an EBV-associated thyroid carcinoma. However, whether these rare thyroid malignancies are related to EBV infection requires further investigation.

Reference: 1. Shimakage M, Kawahara K, Sasagawa T, Inoue H, Yutsudo M, Yoshida A, Yanoma S. Expression of Epstein-Barr virus in thyroid carcinoma correlates with tumor progression. Hum Pathol. 2003;34(11):1170–1177.