
Microcalcifications without a thyroid nodule as the sole sign of papillary thyroid carcinoma
Author(s) -
Stamatina Ioakim,
Vasilis Constantinides,
Meropi Toumba,
Theodoros Lyssiotis,
Angelos Kyriacou
Publication year - 2021
Publication title -
endocrinology, diabetes and metabolism case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.307
H-Index - 7
ISSN - 2052-0573
DOI - 10.1530/edm-21-0072
Subject(s) - thyroid nodules , medicine , nodule (geology) , thyroid , radiology , echogenicity , malignancy , fine needle aspiration , thyroid carcinoma , microcalcification , biopsy , thyroid cancer , thyroidectomy , carcinoma , pathology , ultrasound , cancer , breast cancer , mammography , paleontology , biology
Our objective is to demonstrate the importance of considering microcalcifications even without evidence of nodules as a potential sign of malignancy. Current guidelines, such as those of the British Thyroid Association, acknowledge the clinical significance of microcalcifications only when found within nodules. In this case, they are considered a suspicious feature, classifying the nodules as U5 (i.e. high risk) where fine-needle aspiration biopsy (FNAB) is warranted, following the high likelihood of cancer in these nodules. In addition, there is a dearth of evidence of ultrasound scan (USS) detection of microcalcifications in the thyroid gland outside of nodules, along with their associated clinical implications. Yet, this clinical manifestation is not so infrequent considering that we do encounter patients in the clinic showing these findings upon ultrasound examination. Three patients who presented to our clinic with thyroid-related symptoms were shown to have areas of microcalcifications without a nodule upon sonographic evaluation of their thyroid gland. These incidentally detected hyperechoic foci were later confirmed to correspond to areas of papillary thyroid carcinoma (PTC) on histopathological examination of resected tissue following thyroidectomy. Four more cases were identified with sonographic evidence of microcalcifications without nodules and given their clinical and other sonographic characteristics were managed with active surveillance instead.