Metastatic papillary thyroid carcinoma in pleural effusion: a case report and review of the literature

Abstract Introduction Papillary thyroid carcinoma accounts for the most common type of thyroid cancer of well-differentiated type. Papillary thyroid carcinoma is featured by biologically low-grade and less aggressive tumors with a survival rate of 10 years in most of the diagnosed cases. Papillary t...

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Main Authors: Mohammed Ali Abutalib, Anwar Shams, Shadi Tamur, Eman A. Khalifa, Ghaliah Obaid Alnefaie, Yousef M. Hawsawi
Format: Article
Language:English
Published: BMC 2023-12-01
Series:Journal of Medical Case Reports
Subjects:
Online Access:https://doi.org/10.1186/s13256-023-04265-6
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author Mohammed Ali Abutalib
Anwar Shams
Shadi Tamur
Eman A. Khalifa
Ghaliah Obaid Alnefaie
Yousef M. Hawsawi
author_facet Mohammed Ali Abutalib
Anwar Shams
Shadi Tamur
Eman A. Khalifa
Ghaliah Obaid Alnefaie
Yousef M. Hawsawi
author_sort Mohammed Ali Abutalib
collection DOAJ
description Abstract Introduction Papillary thyroid carcinoma accounts for the most common type of thyroid cancer of well-differentiated type. Papillary thyroid carcinoma is featured by biologically low-grade and less aggressive tumors with a survival rate of 10 years in most of the diagnosed cases. Papillary thyroid carcinoma can be presented with the involvement of cervical lymph nodes in about 50% of the patients, yet distant spread is very uncommon. Case presentation Herein, we discuss a Saudi male patient in his early 50s with a history of papillary thyroid carcinoma who presented to the emergency department complaining of shortness of breath and a radiological finding of hydrothorax. Cytologic examination together with immune-histochemical staining and molecular studies of pleural effusion aspiration concluded the definitive diagnosis of metastatic papillary thyroid carcinoma in the pleural space. Conclusions Papillary thyroid carcinoma seldom causes metastatic niches in the pleural space; this is a rare clinical presentation, nevertheless, a differential diagnosis of thyroid metastasis needs to be excluded. A definitive diagnosis of metastatic papillary thyroid carcinoma can be made using clinical presentation, cytologic examination, immunohistochemical investigation, and molecular testing. The most common mutation found in papillary thyroid carcinoma cases is the V600E mutation found in the BRAF gene, yet these patients have a relatively low probability of cancer recurrence. Patients with papillary thyroid carcinoma who have the BRAF mutation frequently experience metastases and relapses of the disease after the cancer has progressed aggressively. To help with therapy planning and the introduction of BRAF inhibitors, genetic testing for BRAF mutation may therefore prove to be a useful tool, especially in cases of aggressive subtypes of TC.
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spelling doaj.art-04889835463348c4a999c681f3cd409c2023-12-24T12:19:52ZengBMCJournal of Medical Case Reports1752-19472023-12-011711810.1186/s13256-023-04265-6Metastatic papillary thyroid carcinoma in pleural effusion: a case report and review of the literatureMohammed Ali Abutalib0Anwar Shams1Shadi Tamur2Eman A. Khalifa3Ghaliah Obaid Alnefaie4Yousef M. Hawsawi5Clinical Cytologist and Supervisor of Pathology, Department of Laboratory Medicine and Pathology, Division of Anatomical Pathology, King Abdulaziz Medical CityDepartment of Pharmacology, College of Medicine, Taif UniversityDepartment of Pediatric, College of Medicine, Taif UniversityDepartment of Parasitology, College of Medicine, Taif UniversityDepartment of Pathology, College of Medicine, Taif UniversityResearch Center, King Faisal Specialist Hospital and Research CenterAbstract Introduction Papillary thyroid carcinoma accounts for the most common type of thyroid cancer of well-differentiated type. Papillary thyroid carcinoma is featured by biologically low-grade and less aggressive tumors with a survival rate of 10 years in most of the diagnosed cases. Papillary thyroid carcinoma can be presented with the involvement of cervical lymph nodes in about 50% of the patients, yet distant spread is very uncommon. Case presentation Herein, we discuss a Saudi male patient in his early 50s with a history of papillary thyroid carcinoma who presented to the emergency department complaining of shortness of breath and a radiological finding of hydrothorax. Cytologic examination together with immune-histochemical staining and molecular studies of pleural effusion aspiration concluded the definitive diagnosis of metastatic papillary thyroid carcinoma in the pleural space. Conclusions Papillary thyroid carcinoma seldom causes metastatic niches in the pleural space; this is a rare clinical presentation, nevertheless, a differential diagnosis of thyroid metastasis needs to be excluded. A definitive diagnosis of metastatic papillary thyroid carcinoma can be made using clinical presentation, cytologic examination, immunohistochemical investigation, and molecular testing. The most common mutation found in papillary thyroid carcinoma cases is the V600E mutation found in the BRAF gene, yet these patients have a relatively low probability of cancer recurrence. Patients with papillary thyroid carcinoma who have the BRAF mutation frequently experience metastases and relapses of the disease after the cancer has progressed aggressively. To help with therapy planning and the introduction of BRAF inhibitors, genetic testing for BRAF mutation may therefore prove to be a useful tool, especially in cases of aggressive subtypes of TC.https://doi.org/10.1186/s13256-023-04265-6Thyroid cancerPapillary thyroid carcinomaMalignant pleural effusionAspiration cytology
spellingShingle Mohammed Ali Abutalib
Anwar Shams
Shadi Tamur
Eman A. Khalifa
Ghaliah Obaid Alnefaie
Yousef M. Hawsawi
Metastatic papillary thyroid carcinoma in pleural effusion: a case report and review of the literature
Journal of Medical Case Reports
Thyroid cancer
Papillary thyroid carcinoma
Malignant pleural effusion
Aspiration cytology
title Metastatic papillary thyroid carcinoma in pleural effusion: a case report and review of the literature
title_full Metastatic papillary thyroid carcinoma in pleural effusion: a case report and review of the literature
title_fullStr Metastatic papillary thyroid carcinoma in pleural effusion: a case report and review of the literature
title_full_unstemmed Metastatic papillary thyroid carcinoma in pleural effusion: a case report and review of the literature
title_short Metastatic papillary thyroid carcinoma in pleural effusion: a case report and review of the literature
title_sort metastatic papillary thyroid carcinoma in pleural effusion a case report and review of the literature
topic Thyroid cancer
Papillary thyroid carcinoma
Malignant pleural effusion
Aspiration cytology
url https://doi.org/10.1186/s13256-023-04265-6
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