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Mixed medullary‐papillary carcinoma of the thyroid: Report of a case and review of the literature
Author(s) -
Nangue Charlette,
Bron Luc,
Portmann Luc,
Volante Marco,
Ris HansBeat,
Monnier Philippe,
AndrejevicBlant Snezana
Publication year - 2009
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.20984
Subject(s) - medicine , medullary cavity , thyroid carcinoma , micrometastasis , medullary carcinoma , carcinoembryonic antigen , lymph node , thyroid , thyroidectomy , pathology , neck dissection , dissection (medical) , lymphadenectomy , carcinoma , radiology , metastasis , cancer
Abstract Background. Mixed medullary‐follicular thyroid carcinoma denotes a rare and heterogeneous group of tumors displaying morphological and immunophenotypical features of both origins within the same lesion. Method. We report a case of a 41‐year‐old woman with a lump in the right side of the neck, increasing in pain and size over several weeks. Serum levels of calcitonine (1140 ng/L) and carcinoembryonic antigen (288 μg/L) were very high. Fine‐needle aspiration cytology suggested a diagnosis of medullary thyroid carcinoma. Total thyroidectomy, along with bilateral functional neck and mediastinal lymph‐node dissection, were performed. Results. The histopathological examination yielded a diagnosis of medullary carcinoma in the right thyroid lobe, closely intermingled with a nonencapsulated classical papillary carcinoma. One ipsilateral lymph node showed micrometastasis of the medullary counterpart. Conclusion. When compared with other cases reported in literature, this particular presentation should be recognized, if required, morphologic and functional criteria are used. The treatment is mostly surgical, driven by the medullary component. The presence of micrometastasis in 1 ipsilateral cervical lymph‐node underlines the importance of cervicomediastinal lymph‐node dissection and careful searching for metastatic disease. © 2009 Wiley Periodicals, Inc. Head Neck, 2009