HUMANS FEMALE MIDDLE AGED THYROID GLAND THYROIDECTOMY

Hyalinizing trabecular tumor (HTT), a type of thyroid lesion, was first reported by Carney in 1987 and has since been reported continuously. Due to its histological non-specificity, HTT can be misdiagnosed as papillary thyroid cancer or medullary thyroid cancer. For this reason, over treatment might occur; for example, total thyroidectomy and lymphadenectomy. Diagnosis and treatment is a challenge because there is still controversy regarding HTT characters. We report on two cases. One patient was a 48-year-old female and the other was a 46-year-old female. Both patients complained of a thyroid mass and were diagnosed as HTT.
Diagnosis ; Diagnosis, Differential ; Female ; Humans ; Hyalin* ; Lymph Node Excision ; Middle Aged ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroidectomy

We report an extremely rare case of papillary thyroid microcarcinoma (PTMC) in the thyroid Epub ahead of print pyramidal lobe (TPL). A 48-year-old woman underwent ultrasound-guided fine-needle aspiration for a small thyroid nodule in the right lobe in local clinic, and it revealed a malignant cytology. On preoperative ultrasonography for tumor staging in our hospital, another small suspiciously malignant hypoechoic nodule was detected in the left TPL. Total thyroidectomy and central nodal dissection were performed. Histopathology confirmed PTMCs in the left TPL and both thyroid lobes. Ultrasonography for TPL should be required for complete evaluation of possible multifocality of thyroid malignancy.
Biopsy, Fine-Needle ; Female ; Humans ; Middle Aged ; Neoplasm Staging ; Thyroid Gland* ; Thyroid Nodule ; Thyroidectomy ; Ultrasonography

The authors present a rare case of papillary carcinoma arising from the pyramidal lobe of the thyroid in a 54-year-old woman, who presented with a right submental palpable mass. An ultrasound evaluation depicted a 3 cm mixed echoic mass from the thyroid cartilage level without a focal lesion in the thyroid gland. Surgical specimens obtained during bilateral thyroidectomy confirmed papillary carcinoma of the pyramidal lobe. To the authors' knowledge, this is the first case report to describe papillary carcinoma arising from the pyramidal lobe of the thyroid gland.
Carcinoma, Papillary ; Female ; Humans ; Middle Aged ; Thyroid Cartilage ; Thyroid Gland ; Thyroidectomy

52-year-old woman was presented with palpitation and weight loss. Thyroid function test revealed low thyroid-stimulating hormone level with upper normal range of Free T4 and thyroid scan showed 2 cm hot nodule in left upper pole. Thyroid ultrasonography was also done and it showed two nodules in left upper pole. The one was considered as functioning benign nodule, but the other nodule was compatible with malignancy. She underwent total thyroidectomy and final pathology revealed papillary thyroid carcinoma.
Carcinoma ; Female ; Humans ; Middle Aged ; Reference Values ; Thyroid Function Tests ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy ; Thyrotropin ; Weight Loss

Thyroid hemiagenesis is a rare congenital anomaly that is caused by a developmental defect of a thyroid. Previous reports indicate that thyroid cancer associated with hemiagenesis is extremely rare. A 47-year-old woman presented with single nodule in the right thyroid gland that was incidentally detected during a routine medical checkup. Ultrasonography showed a 1.5×1.2 cm sized ill-defined irregular hypoehoic nodule in the right thyroid and the isthmus was present. However, the left thyroid was not seen and thyroid was disconnected at left paraisthmic area. Fine-needle aspiration cytology confirmed that the right thyroid nodule was papillary thyroid carcinoma. Total thyroidectomy with bilateral central compartment node dissection was performed. Permanent pathologic finding was 1.3×1 cm sized classical type papillary thyroid carcinoma with nodular hyperplasia. There was extensive lymphatic invasion and 3 metastatic lymph nodes out of 4 in central compartment. In conclusion, although thyroid hemiagenesis associated with thyroid carcinoma is extremely rare, treatment strategy is not different with patients with normal anatomy. And the possibility of developing a thyroid carcinoma should be considered in patients with hemiagenesis. Furthermore, it requires awareness of anatomical difference around the thyroid gland during operation.
Biopsy, Fine-Needle ; Female ; Humans ; Hyperplasia ; Lymph Nodes ; Middle Aged ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroid Nodule ; Thyroidectomy ; Ultrasonography

A non-recurrent laryngeal nerve is rarely encountered condition, and its anomalous path makes it more vulnerable to injury during thyroid surgery and compression by a thyroid mass. This anomaly appears as a consequence of an aberrant subclavian artery, which arises from an anomaly in the primitive forth aortic arch. So, the surgeon must always be aware of the possibility of a nonrecurrent laryngeal nerve. Pre-operative recognition of this nerve allows surgeons to avoid the nerve injury. In some cases, surgeons are able to predict the presence of this nerve pre-operatively by way of clinical symptoms, chest X-ray or barium swallow. We experienced a case of right nonrecurrent laryngeal nerve during a total thyroidectomy in a 47-year-old female, and report with literature review.
Aorta, Thoracic ; Barium ; Female ; Humans ; Laryngeal Nerves* ; Middle Aged ; Subclavian Artery ; Thorax ; Thyroid Gland ; Thyroidectomy

Riedel's thyroiditis is a rare form of chronic thyroiditis, characterized by a fibroinflammatory process which partially destroys the thyroid, often involving surrounding tissues. The relationship of Riedel's thyroiditis to other forms of thyroiditis is not clear. A case of Riedel's thyroiditis in a 51-year-old female patient, admitted with a previous diagnosis of subacute thyroiditis, is reported. She was first diagnosed with subacute thyroiditis based on clinical manifestation and radiologic and laboratory results. She was treated with glucocorticoid for 8 weeks. The follow-up lasted for 12 months. However, three years later she underwent a thyroidectomy operation due to an enlargement of the thyroid nodule and suspicion of malignancy. Histopathologic examination confirmed that she had Riedel's Thyroiditis. Until now, few case of Riedel's thyroiditis in patients with a history of subacute thyroiditis have been reported in the literature. Although the etiology of Riedel's thyroiditis is unknown, it may develop in the course of subacute thyroiditis.
Diagnosis ; Female ; Follow-Up Studies ; Humans ; Hyperthyroidism ; Middle Aged ; Thyroid Gland* ; Thyroid Nodule ; Thyroidectomy ; Thyroiditis* ; Thyroiditis, Subacute*

A 61-year-old woman who underwent total thyroidectomy for papillary thyroid carcinoma (PTC) five years previously referred for a cervical retrotracheal mass. The mass had intense fluorodeoxyglucose (FDG) uptake on positron emission tomography-computed tomography (PET-CT), and was thus thought to be malignant. Transcutaneous ultrasonography with fine needle aspiration (FNA) was not feasible, so we tried endobronchial ultrasonography (EBUS) with transbronchial needle aspiration (TBNA) to obtain a cytology specimen. After surgery, the mass was confirmed to be a metastatic lymph node from the previous PTC, confirming the TBNA results. Although the utility of EBUS-TBNA for evaluating mediastinal metastasis has been reported in a number of studies, few reports have addressed its utility in the cervical region. Here we report this unusual case of metastatic lymph node of PTC that recurred in the cervical retrotracheal area. It was found to exhibit esophageal muscular invasion, and was accurately diagnosed on EBUS-TBNA.
Biopsy, Fine-Needle ; Electrons ; Female ; Humans ; Lymph Nodes ; Middle Aged ; Needles* ; Neoplasm Metastasis ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy ; Ultrasonography*

We report a case of a 47-year-old female known with metastatic papillary thyroid cancer. Her treatment history included total thyroidectomy and 3 previous radio ablations with a cumulative dose of 950 mCi of ¹³¹I. On follow-up, her thyroglobulin levels had demonstrated a rising trend (from 3789.0 to 4240.0 ug/L) despite a ¹²³I whole-body scan demonstrating a reduction in tracer avid lesions. She was suspected of having radio-resistant disease. The patient underwent both ¹⁸F-FDG and ⁶⁸Ga-PSMA PET/CT imaging with both scans demonstrating congruent lesions however with far greater intensity on the ⁶⁸Ga-PSMA study.
Female ; Follow-Up Studies ; Humans ; Iodine ; Middle Aged ; Positron-Emission Tomography and Computed Tomography ; Thyroglobulin ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy