SESSION TITLE: Cancer Case Report Posters I
SESSION TYPE: Case Report Poster
PRESENTED ON: Sunday, March 23, 2014 at 01:15 PM - 02:15 PM
PURPOSE: Primary thyroid lymphoma is a rare neoplasm, representing 0.6 to 5% of thyroid malignancies.
METHODS: CASE PRESENTATION: 78 year old woman with a history of unexplained hypothyroidism treated with levothyroxine. She began a year before admission when she noted a mass in the anterior neck. During the last month, she developed biphasic stridor and dyspnea. The physical examination showed biphasic stridor, audible at a distance, in addition, the neck had a tumor in the right lobe of the thyroid, hard, fixed to deep planes and the trachea; there were no palpable nodes. Contrasted neck and chest CT scan and sagittal and coronal MRI, showed a 4 x 3 x 6 cm hypodense lobulated lesion, with areas of heterogeneous density, located in the right lobe of the thyroid gland, compressing the right tracheal wall, producing a 80% intraluminal tracheal stenosis.The virtual bronchoscopy of the airway showed compression in the right lateral region of the trachea.
RESULTS: DISCUSSION: Primary thyroid lymphoma is a rare neoplasm, representing 0.6 to 5% of thyroid malignancies, less than 2% of extranodal lymphomas and 1 to 6% of malignant thyroid pathology. It is associated with autoimmune thyroiditis in 90% of cases and with chronic thyroiditis in 25 to 44%. Hashimoto's thyroiditis occurs in two different clinical forms: nodular or diffuse. Medical treatment is indicated in patients with hypo or hyperthyroidism. Surgical treatment is indicated in patients with increased gland volume, when medical treatment fails or the tumor is in one or more nodules or it has infiltrated the airway. Hashimoto's thyroiditis is associated with papillary thyroid carcinoma in up to 59.7% of cases. However, the association of these three entities: Hashimoto's thyroiditis, papillary carcinoma and primary lymphoma is exceptional; there are only four cases reported in the literature. The unusual association of these three diseases requires to be treated by a multidisciplinary team. The initial surgical approach is essential for its treatment, because it influences the survival of patients.
CONCLUSIONS: The unusual association of these three diseases requires to be treated by a multidisciplinary team.
CLINICAL IMPLICATIONS: The unusual association of these three diseases requires to be treated by a multidisciplinary team.
DISCLOSURE: The following authors have nothing to disclose: Francina Bolanos, Emmanuel Peña Gomezportugal, Enrique Guzman del alba, Patricio Santillán Doherty, Fortunato Juarez
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