Protruding Huge Thyroid Mass Concurrent Hemorrhage and Skin Necrosis: A Case Report
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Papillary thyroid carcinoma (PTC), a prevalent subtype of thyroid cancer, is typically characterized by slow growth and a favorable prognosis. However, this report presents an unusual case of PTC with tall cell features that exhibited rapid growth, extensive extrathyroidal extension and skin necrosis. The patient’s thyroid mass, considerably increased in size within a few weeks, reaching over 10 cm in diameter. The mass was associated with skin necrosis and hemorrhage and consisted of both cystic and solid components. Due to the risk of hemorrhage, preoperative fine needle aspiration biopsy was not performed. A computed tomography scan confirmed a large mixed cystic and solid mass with tracheal deviation and enlarged lymph node (LN). Total thyroidectomy with lateral neck dissection, and wound reconstruction was performed. Pathological examination revealed PTC with tall cell features and LNs were harvested in a total of 28, with only one LN showing confirmed metastasis. In clinical practice, encountering patients with rapidly growing, exceptionally large cystic masses should raise awareness about the potential presence of PTC, as demonstrated in this case.
Abstract
Papillary thyroid carcinoma (PTC), a prevalent subtype of thyroid cancer, is typically characterized by slow growth and a favorable prognosis. However, this report presents an unusual case of PTC with tall cell features that exhibited rapid growth, extensive extrathyroidal extension and skin necrosis. The patient’s thyroid mass, considerably increased in size within a few weeks, reaching over 10 cm in diameter. The mass was associated with skin necrosis and hemorrhage and consisted of both cystic and solid components. Due to the risk of hemorrhage, preoperative fine needle aspiration biopsy was not performed. A computed tomography scan confirmed a large mixed cystic and solid mass with tracheal deviation and enlarged lymph node (LN). Total thyroidectomy with lateral neck dissection, and wound reconstruction was performed. Pathological examination revealed PTC with tall cell features and LNs were harvested in a total of 28, with only one LN showing confirmed metastasis. In clinical practice, encountering patients with rapidly growing, exceptionally large cystic masses should raise awareness about the potential presence of PTC, as demonstrated in this case.
참고문헌 (17)
- Lloyd RV, "Papillary thyroid carcinoma variants", Head Neck Pathol, 5, pp.51~56 (2011)
- La Vecchia C, "Thyroid cancer mortality and incidence : a global overview", Int J Cancer, 136, pp.2187~2195 (2015)
- LiVolsi VA, "Papillary carcinoma tall cell variant(TCV) : a review", Endocr Pathol, 21, pp.12~15 (2010)
- LiVolsi VA, "Papillary thyroid carcinoma : an update", Mod Pathol, 24(Suppl 2), pp.S1~S9 (2011)
- Jun P, "The sonographic features of papillary thyroid carcinomas : pictorial essay", Ultrasound Q, 21, pp.39~45 (2005)
- Sampson E, "Clinical management and outcome of papillary and follicular(differentiated)thyroid cancer presenting with distant metastasis at diagnosis", Cancer, 110, pp.1451~1456 (2007)
- Ito Y, "Risk factors for recurrence to the lymph node in papillary thyroid carcinoma patients without preoperatively detectable lateral node metastasis : validity of prophylactic modified radical neck dissection", World J Surg, 31, pp.2085~2091 (2007)
- Jin BJ, "Characteristics and significance of minimal and maximal extrathyroidal extension in papillary thyroid carcinoma", Oral Oncol, 51, pp.759~763 (2015)
- Hervás Benito I, "Simple thyroid cyst", Rev Esp Med Nucl, 20, pp.32~35 (2001)
- Abusabeib A, "First case of huge classic papillary thyroid cancer rupturing spontaneously leading to ischemic necrosis, perforation and inflammation of overlying skin : case report and review of the literature", Int J Surg Case Rep, 85, pp.106136~ (2021)
- Choi JB, "Oncologic outcomes in patients with 1-cm to 4-cm differentiated thyroid carcinoma according to extent of thyroidectomy", Head Neck, 41, pp.56~63 (2019)
- 정종주, "A Scoring System for Prediction of Lateral Neck Node Metastasis from Papillary Thyroid Cancer", Journal of Korean Medical Science, 26(8), pp.996~1000 (2011), 대한의학회
- Chaudhary V, "Thyroid ultrasound", Indian J Endocrinol Metab, 17, pp.219~227 (2013)
- Haugen BR, "2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer : the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer", Thyroid, 26, pp.1~133 (2016)
- Bin Saeedan M, "Thyroid computed tomography imaging : pictorial review of variable pathologies", Insights Imaging, 7, pp.601~617 (2016)
- 오우진, "Classic Papillary Thyroid Carcinoma with Tall Cell Features and Tall Cell Variant Have Similar Clinicopathologic Features", Journal of Pathology and Translational Medicine, 48(3), pp.201~208 (2014), 대한병리학회[DOI]
- Bikas A, "Papillary thyroid carcinomas with tall cell features : an intermediate entity between classic and tall cell subtypes", Thyroid, 33, pp.697~704 (2023)