Complete resection of ulcerating, infiltrative, voluminous differentiated thyroid carcinoma
Résumé
An 87-year-old woman was referred to our department, for a 15cm right-sided cervical tumor with impressive external extension and skin ulceration. At first, anaplastic thyroid carcinoma was feared but after surgical evaluation, the patient was finally operated on and the tumor was entirely resected. The histological analysis revealed a 16 cm PTC with polymorphic well-differentiated subtypes (classic variants, tall cells, Warthin-like variant, columnar cells) extending to the skin, with cervical lymphadenopathies up to 2.9 cm in diameter, in the right lateral areas, pT4a(m)N1b. Considering BRAFV600E and TERT promoter mutations, along with patient’s advanced age with low autonomy, multidisciplinary decision was in agreement to avoid iodine treatment. Our case highlights the benefit to consider surgery in the context of a tertiary care center even for apparent massive aggressive cervical mass and despite patient advanced age. At 7 months from the initial surgery, the patient was free of symptom related to the remaining metastatic disease and her vital functions were preserved.
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[22350802 - European Thyroid Journal] Unexpected complete resection of a historically voluminous differentiated thyroid carcinoma.pdf (237.42 Ko)
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