Haggi Mazeh1, Amir Orlev1, Ido Mizrahi1, David J Gross2, Herbert R Freund1. 1. Department of SurgeryEndocrinology and Metabolism Service Hadassah-Hebrew University Medical Center, Jerusalem, Israel. 2. Endocrinology and Metabolism Service Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Abstract
BACKGROUND: Papillary thyroid carcinoma is the most common thyroid cancer (85%). Follicular thyroid carcinoma is the second most common type of thyroid cancer, accounting for up to 10% of all thyroid cancers. Medullary thyroid carcinoma accounts for only 5-8% of thyroid cancers. Concurrent medullary, follicular, and papillary carcinomas of the thyroid gland are extremely rare and reported scarcely. CASE REPORT: A 72-year-old male presented with nonspecific neck pain. The workup revealed a nodular thyroid gland with a follicular lesion on fine-needle aspiration. Total thyroidectomy was performed and pathological examination identified a 25-mm follicular carcinoma, two papillary microcarcinomas, and two medullary microcarcinomas. The genetic workup was negative and no other family members were diagnosed with any endocrinopathy. Two months after surgery, the patient was diagnosed with Cushing's syndrome that was treated with laparoscopic left adrenalectomy. On 3-year follow-up, the patient is asymptomatic with no evidence of recurrent disease. CONCLUSION: We present a rare case of a patient with follicular, papillary, and medullary thyroid carcinoma, and Cushing's syndrome. To date, no known genetic mutation or syndrome can account for this combination of neoplastic thyroid and adrenal pathologies, although future research may prove differently.
BACKGROUND:Papillary thyroid carcinoma is the most common thyroid cancer (85%). Follicular thyroid carcinoma is the second most common type of thyroid cancer, accounting for up to 10% of all thyroid cancers. Medullary thyroid carcinoma accounts for only 5-8% of thyroid cancers. Concurrent medullary, follicular, and papillary carcinomas of the thyroid gland are extremely rare and reported scarcely. CASE REPORT: A 72-year-old male presented with nonspecific neck pain. The workup revealed a nodular thyroid gland with a follicular lesion on fine-needle aspiration. Total thyroidectomy was performed and pathological examination identified a 25-mm follicular carcinoma, two papillary microcarcinomas, and two medullary microcarcinomas. The genetic workup was negative and no other family members were diagnosed with any endocrinopathy. Two months after surgery, the patient was diagnosed with Cushing's syndrome that was treated with laparoscopic left adrenalectomy. On 3-year follow-up, the patient is asymptomatic with no evidence of recurrent disease. CONCLUSION: We present a rare case of a patient with follicular, papillary, and medullary thyroid carcinoma, and Cushing's syndrome. To date, no known genetic mutation or syndrome can account for this combination of neoplastic thyroid and adrenal pathologies, although future research may prove differently.
Authors: David S Cooper; Gerard M Doherty; Bryan R Haugen; Bryan R Hauger; Richard T Kloos; Stephanie L Lee; Susan J Mandel; Ernest L Mazzaferri; Bryan McIver; Furio Pacini; Martin Schlumberger; Steven I Sherman; David L Steward; R Michael Tuttle Journal: Thyroid Date: 2009-11 Impact factor: 6.568
Authors: Venu G Pillarisetty; Steven C Katz; Ronald A Ghossein; R Michael Tuttle; Ashok R Shaha Journal: Ann Surg Oncol Date: 2009-07-01 Impact factor: 5.344
Authors: Kenko Cupisti; A Raffel; U Ramp; A Wolf; A Donner; M Krausch; C F Eisenberger; W T Knoefel Journal: Endocr J Date: 2005-04 Impact factor: 2.349
Authors: Dana T Yip; Maria Hassan; Kalliopi Pazaitou-Panayiotou; Daniel T Ruan; Atul A Gawande; Randall D Gaz; Francis D Moore; Richard A Hodin; Antonia E Stephen; Peter M Sadow; Gilbert H Daniels; Gregory W Randolph; Sareh Parangi; Carrie C Lubitz Journal: Surgery Date: 2011-12 Impact factor: 3.982
Authors: Herbert Chen; Rebecca S Sippel; M Sue O'Dorisio; Aaron I Vinik; Ricardo V Lloyd; Karel Pacak Journal: Pancreas Date: 2010-08 Impact factor: 3.327
Authors: Michael N Pakdaman; Louise Rochon; Olguta Gologan; Michael Tamilia; Natasha Garfield; Michael P Hier; Martin J Black; Richard J Payne Journal: Otolaryngol Head Neck Surg Date: 2008-11 Impact factor: 3.497
Authors: Kevin Cheung; Sanziana A Roman; Tracy S Wang; Hugh D Walker; Julie Ann Sosa Journal: J Clin Endocrinol Metab Date: 2008-03-25 Impact factor: 5.958
Authors: Abdelrahman Abdelaal; Walid El Ansari; Abdelrahman Abusabeib; Hanan Farghaly; Abdelhakem A M Tabeb Journal: Int J Surg Case Rep Date: 2020-06-20