We present the case of a 47-year-old Caucasian previously healthy woman with a voluminous thyroid nodule occupying almost the entire anterior neck region. The lesion had progressively increased in size during the previous 3 months and the patient presented intermittent symptoms of dysphagia and odynophagia with a slight change in voice. Fine needle aspiration showed papillary carcinoma. Based on imaging and cytological findings, the patient underwent total thyroidectomy. The surgical sample revealed a totally enlarged thyroid gland (weight: 208 g) with the presence of a poly-lobulated lesion centrally located and involving the isthmus and both lobes. Hobnail features were present in more than 30% of the neoplastic cells in agreement with the criteria for this subtype. Psammoma bodies and focal necrosis were also present. The extra-thyroidal extension included strap muscles and peri-esophageal glands. Immunohistochemistry using VE1 antibody for detecting BRAF-V600E mutation resulted positive. The final diagnosis was papillary thyroid carcinoma (PTC) hobnail variant (HVPTC)-pT4a. The HVPTC is a rare entity and, in most cases, appears like a unifocal lesion with a maximum tumor size of 8 cm reported so far. To our knowledge, this represents the largest tumor ever described (14 cm), showing rapid growth and with multinodular goiter-like aspect.

Hobnail variant of papillary thyroid carcinoma showing goiter-like presentation and rapid growth / Naciu, Anda Mihaela; Verri, Martina; Crescenzi, Anna; Taffon, Chiara; Longo, Filippo; Frasca, Luca; Tabacco, Gaia; Monte, Lavinia; Palermo, Andrea; Crucitti, Pierfilippo; Cesareo, Roberto. - In: ENDOCRINOLOGY, DIABETES & METABOLISM CASE REPORTS. - ISSN 2052-0573. - 2021:(2021). [10.1530/EDM-20-0184]

Hobnail variant of papillary thyroid carcinoma showing goiter-like presentation and rapid growth

Crescenzi, Anna;
2021

Abstract

We present the case of a 47-year-old Caucasian previously healthy woman with a voluminous thyroid nodule occupying almost the entire anterior neck region. The lesion had progressively increased in size during the previous 3 months and the patient presented intermittent symptoms of dysphagia and odynophagia with a slight change in voice. Fine needle aspiration showed papillary carcinoma. Based on imaging and cytological findings, the patient underwent total thyroidectomy. The surgical sample revealed a totally enlarged thyroid gland (weight: 208 g) with the presence of a poly-lobulated lesion centrally located and involving the isthmus and both lobes. Hobnail features were present in more than 30% of the neoplastic cells in agreement with the criteria for this subtype. Psammoma bodies and focal necrosis were also present. The extra-thyroidal extension included strap muscles and peri-esophageal glands. Immunohistochemistry using VE1 antibody for detecting BRAF-V600E mutation resulted positive. The final diagnosis was papillary thyroid carcinoma (PTC) hobnail variant (HVPTC)-pT4a. The HVPTC is a rare entity and, in most cases, appears like a unifocal lesion with a maximum tumor size of 8 cm reported so far. To our knowledge, this represents the largest tumor ever described (14 cm), showing rapid growth and with multinodular goiter-like aspect.
2021
*
01 Pubblicazione su rivista::01i Case report
Hobnail variant of papillary thyroid carcinoma showing goiter-like presentation and rapid growth / Naciu, Anda Mihaela; Verri, Martina; Crescenzi, Anna; Taffon, Chiara; Longo, Filippo; Frasca, Luca; Tabacco, Gaia; Monte, Lavinia; Palermo, Andrea; Crucitti, Pierfilippo; Cesareo, Roberto. - In: ENDOCRINOLOGY, DIABETES & METABOLISM CASE REPORTS. - ISSN 2052-0573. - 2021:(2021). [10.1530/EDM-20-0184]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1700031
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