Simultaneous Occurrence of Papillary Carcinoma and Medullary Carcinoma
The cell origin, histopathologic features, and prognosis of medullary and papillary thyroid carcinoma are different and to have them occur simultaneously in a single patient is a rare occurrence.
This is a case of a 38-year-old female who presented with an enlarging anterior neck mass whose fine needle aspiration biopsy could not rule out a papillary lesion. Thus, she was advised to undergo total thyroidectomy, and her final histopath showed a simultaneous medullary and papillary thyroid carcinoma. Her initial serum calcitonin was elevated at 252 pg/ ml, and it remained persistently elevated over the course of 7 months. A repeat ultrasound revealed solid nodules with coarse calcifications and enlarged lymph nodes at both submandibular regions. This warranted a repeat surgery with neck dissection with the finding of eight lymph nodes positive for metastatic carcinoma. On follow up after her second surgery, the calcitonin decreased to 42.70 pg/ml.
Knowledge of this simultaneous occurrence of medullary thyroid carcinoma and papillary cancer is important for its prognostic implications and therapeutic plan.
Katoh H, Yamashita K, Enomoto T, Watanabe M. Classification and general considerations of thyroid cancer. Ann Clin Pathol. 2015;3:1045.
Erhamamci S, Reyhan M, Koçer NE, Nursal GN, Torun N, Yapar AF. Simultaneous occurrence of medullary and differentiated thyroid carcinomas. Report of 4 cases and brief review of the literature. Hell J Nucl Med. 2014;17(2):148-52. https://www.ncbi.nlm.nih.gov/pubmed/24997082. https://doi.org/10.1967/s002449910137.
Machens A, Dralle H. Simultaneous medullary and papillary thyroid cancer: a novel entity? Ann Surg Oncol. 2012;19(1):37-44. https://www.ncbi.nlm.nih.gov/pubmed/21626080. https://doi.org/10.1245/s10434-011-1795-z.
Adnan Z, Arad E, Dana J, Shendler Y, Baron E. Simultaneous occurrence of medullary and papillary thyroid microcarcinomas: A case series and review of the literature. J Med Case Rep. 2013;7:26. https://www.ncbi.nlm.nih.gov/pubmed/23336429. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3552861. https://doi.org/10.1186/1752- 1947-7-26.
Dionigi G, Castano P, Bertolini V, et al. Simultaneous medullary and papillary thyroid cancer: two case reports. J Med Case Rep. 2007;1:133. https://www.ncbi.nlm.nih.gov/pubmed/17997826. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2194707. https://doi. org/10.1186/1752-1947-1-133.
Copyright (c) 2019 Journal of the ASEAN Federation of Endocrine Societies
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Journal of the ASEAN Federation of Endocrine Societies is licensed under a Creative Commons Attribution-NonCommercial 4.0 International. (full license at this link: http://creativecommons.org/licenses/by-nc/3.0/legalcode).
To obtain permission to translate/reproduce or download articles or use images FOR COMMERCIAL REUSE/BUSINESS PURPOSES from the Journal of the ASEAN Federation of Endocrine Societies, kindly fill in the Permission Request for Use of Copyrighted Material and return as PDF file to email@example.com or firstname.lastname@example.org.
A written agreement shall be emailed to the requester should permission be granted.