Gynecological malignancy mimicking a thyroid lymph node metastasis
We present the case of a 69-year-old woman who attended the Endocrinology Unit of Modena for a suspicious lymph node in the left cervical compartment discovered during the follow-up of a recurrent gynecological malignancy. At neck ultrasonography, a thyroid goiter was detected, and the further cytol...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Bioscientifica
2021-01-01
|
| Series: | Endocrinology, Diabetes & Metabolism Case Reports |
| Online Access: | https://edm.bioscientifica.com/view/journals/edm/2021/1/EDM20-0055.xml |
| _version_ | 1818575093219983360 |
|---|---|
| author | Simone Pederzoli Giorgia Spaggiari Giuditta Bernardelli Francesco Mattioli Cinzia Baldessari Antonino Maiorana Vincenzo Rochira Daniele Santi |
| author_facet | Simone Pederzoli Giorgia Spaggiari Giuditta Bernardelli Francesco Mattioli Cinzia Baldessari Antonino Maiorana Vincenzo Rochira Daniele Santi |
| author_sort | Simone Pederzoli |
| collection | DOAJ |
| description | We present the case of a 69-year-old woman who attended the Endocrinology Unit of Modena for a suspicious lymph node in the left cervical compartment discovered during the follow-up of a recurrent gynecological malignancy. At neck ultrasonography, a thyroid goiter was detected, and the further cytological examination was inconclusive for thyroid nodule and compatible with a localization of an adenocarcinoma with papillary architecture for the lymph node. The histological examination after a left neck dissection confirmed the presence of an intracapsular metastasis of a papillary carcinoma immunohistochemically focally positive for thyroid transcription factor 1 and paired box 8 and negative for thyroglobulin. Subsequently, in the suspicion of a thyroid primitiveness, a total thyroidectomy was performed, revealing an intraparenchymal follicular variant of papillary thyroid carcinoma of 2 mm in the right lobe. During the follow-up, the appearance of a suspected cervical metastatic lesion led to another neck dissection, histologically compatible with a papillary carcinoma localization, immunohistochemically focally positive for thyroid transcription factor 1 and paired box 8, and negative for thyroglobulin. The histological revision of surgical specimens suggests the cervical recurrence of the prior gynecological cancer, rather than a thyroid carcinoma metastasis. The case described shows how carefully the cytological, histological and immunoistochemical results must be evaluated in oncological management, considering the whole patient’s history. |
| first_indexed | 2024-12-15T00:35:40Z |
| format | Article |
| id | doaj.art-1c64c2820e0c4ed1bd504939a2ae531e |
| institution | Directory Open Access Journal |
| issn | 2052-0573 2052-0573 |
| language | English |
| last_indexed | 2024-12-15T00:35:40Z |
| publishDate | 2021-01-01 |
| publisher | Bioscientifica |
| record_format | Article |
| series | Endocrinology, Diabetes & Metabolism Case Reports |
| spelling | doaj.art-1c64c2820e0c4ed1bd504939a2ae531e2022-12-21T22:41:48ZengBioscientificaEndocrinology, Diabetes & Metabolism Case Reports2052-05732052-05732021-01-01111810.1530/EDM-20-0055Gynecological malignancy mimicking a thyroid lymph node metastasisSimone Pederzoli0Giorgia Spaggiari1Giuditta Bernardelli2Francesco Mattioli3Cinzia Baldessari4Antonino Maiorana5Vincenzo Rochira6Daniele Santi7Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy; Unit of Endocrinology, Department of Biomedical, Metabolic and Neural SciencesUnit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Modena, ItalyDepartment of Pathology, University of Modena and Reggio Emilia, Modena, ItalyDepartment of Otorhinolaryngology-Head and Neck SurgeryDepartment of Oncology and Haematology, Azienda Ospedaliero-Universitaria of Modena, Modena, ItalyDepartment of Pathology, University of Modena and Reggio Emilia, Modena, ItalyUnit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy; Unit of Endocrinology, Department of Biomedical, Metabolic and Neural SciencesUnit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy; Unit of Endocrinology, Department of Biomedical, Metabolic and Neural SciencesWe present the case of a 69-year-old woman who attended the Endocrinology Unit of Modena for a suspicious lymph node in the left cervical compartment discovered during the follow-up of a recurrent gynecological malignancy. At neck ultrasonography, a thyroid goiter was detected, and the further cytological examination was inconclusive for thyroid nodule and compatible with a localization of an adenocarcinoma with papillary architecture for the lymph node. The histological examination after a left neck dissection confirmed the presence of an intracapsular metastasis of a papillary carcinoma immunohistochemically focally positive for thyroid transcription factor 1 and paired box 8 and negative for thyroglobulin. Subsequently, in the suspicion of a thyroid primitiveness, a total thyroidectomy was performed, revealing an intraparenchymal follicular variant of papillary thyroid carcinoma of 2 mm in the right lobe. During the follow-up, the appearance of a suspected cervical metastatic lesion led to another neck dissection, histologically compatible with a papillary carcinoma localization, immunohistochemically focally positive for thyroid transcription factor 1 and paired box 8, and negative for thyroglobulin. The histological revision of surgical specimens suggests the cervical recurrence of the prior gynecological cancer, rather than a thyroid carcinoma metastasis. The case described shows how carefully the cytological, histological and immunoistochemical results must be evaluated in oncological management, considering the whole patient’s history.https://edm.bioscientifica.com/view/journals/edm/2021/1/EDM20-0055.xml |
| spellingShingle | Simone Pederzoli Giorgia Spaggiari Giuditta Bernardelli Francesco Mattioli Cinzia Baldessari Antonino Maiorana Vincenzo Rochira Daniele Santi Gynecological malignancy mimicking a thyroid lymph node metastasis Endocrinology, Diabetes & Metabolism Case Reports |
| title | Gynecological malignancy mimicking a thyroid lymph node metastasis |
| title_full | Gynecological malignancy mimicking a thyroid lymph node metastasis |
| title_fullStr | Gynecological malignancy mimicking a thyroid lymph node metastasis |
| title_full_unstemmed | Gynecological malignancy mimicking a thyroid lymph node metastasis |
| title_short | Gynecological malignancy mimicking a thyroid lymph node metastasis |
| title_sort | gynecological malignancy mimicking a thyroid lymph node metastasis |
| url | https://edm.bioscientifica.com/view/journals/edm/2021/1/EDM20-0055.xml |
| work_keys_str_mv | AT simonepederzoli gynecologicalmalignancymimickingathyroidlymphnodemetastasis AT giorgiaspaggiari gynecologicalmalignancymimickingathyroidlymphnodemetastasis AT giudittabernardelli gynecologicalmalignancymimickingathyroidlymphnodemetastasis AT francescomattioli gynecologicalmalignancymimickingathyroidlymphnodemetastasis AT cinziabaldessari gynecologicalmalignancymimickingathyroidlymphnodemetastasis AT antoninomaiorana gynecologicalmalignancymimickingathyroidlymphnodemetastasis AT vincenzorochira gynecologicalmalignancymimickingathyroidlymphnodemetastasis AT danielesanti gynecologicalmalignancymimickingathyroidlymphnodemetastasis |