Cases reported "Carcinoma, Papillary"

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1/170. Tall cell variant of papillary thyroid carcinoma with foci of columnar cell component.

    We report a case of the tall call variant of papillary thyroid carcinoma with foci of columnar cell component in a 67-year-old Japanese man. Tall cell variant occupied more than 70% of the tumour, and columnar cell component was of two types in representative sections. One showed striking stratification of nuclei with scanty cytoplasm, and the other appeared clear. Characteristic nuclear features of papillary carcinoma were also observed in the area of the tall cell variant. The patient died of the thyroid cancer with aspiration pneumonia 10 years and 6 months after operation. Although autopsy was not performed, metastatic lymph nodes of the neck removed during life also showed papillary carcinoma with both tall cell and columnar cell components. Our case indicates that tall cell and columnar cell variants may coexist in the same tumour although the pathogenesis remains unclear.
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2/170. Mucosa-associated lymphoid tissue (MALT) lymphoma of the thyroid: report of a case.

    The patient was 59-year-old Japanese woman who presented with a neck swelling. ultrasonography and computed tomography demonstrated a round tumor in the thyroid right lobe measuring 2.5 x 1.5 cm in size. A right hemithyroidectomy with lymph node dissection was performed. Histopathological findings demonstrated low-grade B cell lymphoma of the mucosa-associated lymphoid tissue (MALT) associated papillary microcarcinoma. A previous report showed an excellent prognosis of MALT lymphoma of the thyroid without capsular invasion or lymph node involvement. We also describe the concept of MALT lymphoma as a primary lesion in which lymphoid tissue is not present in the normal state.
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3/170. Tall cell variant of papillary carcinoma coexisting with chronic lymphocytic thyroiditis. A case report.

    BACKGROUND: Recent studies have shown a correlation between lymphocytic thyroiditis and papillary carcinoma of the thyroid. It is thought that autoimmune thyroiditis could be a risk factor for the development of thyroid carcinoma, mainly for the papillary variant. CASE: A 59-year-old female presented with a history of enlargement in the neck and five months of dysphagia. Clinical examination showed generalized expansion and an increase in the hardness of the thyroid gland. Hormonal outline showed subclinical hypothyroidism with serum levels of TSH slightly elevated (5 micrograms/dL; range, 0.25-4). thyroglobulin antibodies and thyroperoxidase titers were moderately positive. Given these results, a diagnosis of chronic thyroiditis was made. Thyroid ultrasound scan showed diffuse gland irregularity and the presence of a solitary nodule (2.3 cm in diameter) localized in the right lobe. Fine needle aspiration biopsy (FNAB) of the nodule was performed under ultrasound guidance. CONCLUSION: Although clinical and laboratory results supported the diagnosis of autoimmune thyroiditis only, FNAB of the nodular lesion provided evidence of a rare case of papillary carcinoma, tall cell variant, confirmed by histologic results.
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4/170. Metastatic thyroid carcinoma of the mandibule.

    A case of metastatic papillary carcinoma to the mandible is presented. Though relatively rare, metastatic tumours of the mandible should be included in the differential diagnosis of the tumours in the parotid region. For the primary site; being in the cervicofacial region, the thyroid gland must be considered by the head and neck surgeon.
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5/170. hyperthyroidism due to papillary carcinoma of the thyroid--a case report.

    A rare case of papillary carcinoma of the thyroid producing hyperthyroidism is presented. A young patients presented seven years after a thyroid operation with metastatic disease in the cervical lymph nodes and a history of deteriorating vision in the left eye. He also had a lesion in the base of the skull which could not be established to be metastasis from the thyroid cancer. There was clinical and biochemical evidence of hyperthyroidism. Radionuclide scan revealed uptake in the residual thyroid tissue and patchy uptake by the cervical lymph nodes. The patient underwent a complete thyroidectomy and radical neck dissection of the left side and 'berry-picking' of the lymph nodes on the right side. Although the patient became euthyroid post-operatively, his general condition deteriorated and he rapidly lost vision in both eyes before any ablative therapy could be instituted for the tumour in the base of the skull. The patient was lost to follow-up.
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6/170. Thyroid papillary carcinoma arising in ectopic thyroid tissue within a branchial cleft cyst.

    A case of papillary carcinoma arising in ectopic thyroid tissue within a branchial cleft cyst is described. A 46-year-old woman presented with a 2.0 x 2.0 cm mass in her left lateral neck. The excised mass showed a cystic lesion with a thyroid papillary carcinoma. Following a lateral cervical cystectomy, subsequent thyroid gland and lymph nodes dissections were performed. Pathological examination showed an adenomatous goiter and no primary carcinoma in the thyroid gland, as well as metastatic papillary carcinoma in the lymph nodes. Two cases of thyroid papillary carcinoma arising in ectopic thyroid tissue within a branchial cyst have been reported previously, but no lymph node metastases were recognized. The first case of papillary carcinoma arising in ectopic thyroid tissue within a branchial cleft cyst, and accompanied by lymph node metastasis is presented.
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7/170. A case of extraadrenal pheochromocytoma associated with adrenal cortical nodular hyperplasia and papillary thyroid carcinoma.

    A 64-year-old woman was admitted in November, 1996 for fluctuating blood pressure. There was multinodular goiter in her neck. High urine VMA and serum aldosterone were noted. Computed tomography showed an oval lesion in the left adrenal gland. Left adrenalectomy was performed and the pathology was proved to be adrenal cortical nodular hyperplasia. Fluctuating blood pressure and high urine VMA persisted after the operation. CT scan of the abdomen revealed a soft tissue mass in lower abdomen. The patient was admitted again in September, 1997. Laboratory examinations showed normal serum aldosterone, normal plasma renin activity and high urine VMA. Aspiration cytology of the thyroid gland disclosed papillary thyroid carcinoma. [131I]-metaiodobenzylguanidine image revealed a high uptake lesion in the right L-3 paravertebral area. Tumor excision and thyroidectomy were performed. The pathology was reported as extraadrenal pheochromocytoma and papillary thyroid carcinoma. Papillary thyroid carcinoma is rarely associated with pheochromocytoma. To our knowledge, this paper is the first report of a patient with extraadrenal pheochromocytoma associated with papillary thyroid carcinoma and adrenal cortical nodular hyperplasia.
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8/170. Cervical metastasis of occult papillary thyroid carcinoma associated with epidermoid carcinoma of the larynx.

    An occult, laterocervical papillary thyroid carcinoma tissue was found in a functional neck dissection for larynx cancer. The patient was a 76-year-old man with a history of smoking and alcohol ingestion who presented with a supraglottic carcinoma of the larynx located at the laryngeal surface of the epiglottis, left aryepiglottic fold, band and left ventricle with extension to the left vocal cord. light microscopy showed a lymph node with a fibrous stroma with lymphoid follicles that presented a total substitution of the parenchyma by a papillary thyroid carcinoma. Although examination of the thyroid gland by seriated sections did not reveal any neoplasm, we argue that the papillary thyroid tissue is metastatic.
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9/170. Mediastinal lymph node involvement as the initial manifestation of occult thyroid cancer in the surgical treatment of lung cancer: report of a case.

    A 63-year-old man was referred to our institute for the treatment of squamous cell carcinoma of the upper lobe of his right lung. A right upper lobectomy of the lung was performed with a mediastinal lymph node dissection. The postoperative pathological examination of the dissected specimens revealed one of the superior mediastinal lymph nodes to be morbid with micrometastasis of occult thyroid cancer, while no node involvement was seen due to lung cancer. A right lobectomy of the thyroid gland with a modified radical neck dissection was done 4 years later after the confirmation of the absence of any recurrent sign of lung cancer. In the resected specimen, papillary thyroid microcarcinoma was observed with several intraglandular metastases and right regional lymph node involvement. Eight months later, a new primary lung cancer developed in the left lung, and a left upper lobectomy of the lung with a mediastinal lymph node dissection was performed. At that time, the absence of mediastinal lymph node metastasis from lung cancer or thyroid cancer was confirmed. Mediastinal lymph node involvement as the initial manifestation of occult thyroid cancer in surgical treatment for lung cancer is rare, but it is important to be aware of the possibility of incidentally detecting occult thyroid cancer in surgical dissections in this area for lung cancer. The appropriate surgical treatment should be determined while carefully considering the prognosis of the lung cancer as well as that of any coexisting malignancy.
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10/170. Papillary carcinoma in a thyroglossal duct: case report.

    CONTEXT: Thyroglossal duct cysts are the most common congenital cervical abnormality in childhood. Malignant lesions are rare in thyroglossal duct cysts (about 1%). OBJECTIVE: To report a case of papillary carcinoma in thyroglossal duct cysts. DESIGN: Case report. CASE REPORT: The patient was a 21-year-old female with a four-month history of an anterior midline neck mass but without other symptoms. The physical examination revealed a 4.0 cm diameter, smooth, painless, cystic nodule at the level of the hyoid bone. The thyroid gland was normal by palpation and no neck lymph nodes were found. Indirect laryngoscopy, fine-needle biopsy aspiration and cervical ultrasound were normal and compatible with the physical findings of a thyroglossal duct cyst. The patient underwent surgery with this diagnosis, under general anesthesia, and the mass was resected by the usual Sistrunk procedure. There were no local signs of invasion of the tissue surrounding the cyst or duct at surgery. The patient was discharged within 24 hours. Histopathological examination of the specimen showed a 3.5 x 3.0 x 3.0 cm thyroglossal cyst, partially filled by a solid 1.0 x 0.5 cm brownish tissue. Histological sections showed a papillary carcinoma in the thyroid tissue of a thyroglossal cyst, with normal thyroid tissue at the boundary of the carcinoma. There was no capsule invasion and the margins were negative. The follow-up of the patient consisted of head and neck examinations, ultrasonography of the surgical region and thyroid, and total body scintigraphy. The patient has been followed up for two years with no further evidence of disease.
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