Papillary Microcarcinoma in Multinodular Goiter with Lymphocytic Thyroiditis

Abstract

Multi nodular goitre (MNG) is one of the common presentations of various thyroid diseases. Hitherto issue is whether MNG is significantly associated with malignancy. Various studies have reported a 7 to 17% incidence of malignancy in MNG; most common documented is papillary carcinoma. Here we present a case of 40 year old woman with complains of neck swelling, since 10 months. No history of hypertension and other endocrine disorders. The laboratory investigation shows subclinical hyperthyroidism. Ultrasonography (USG) of anterior neck showed a hypoechoic nodule at right lobe. Cytological diagnosis of colloid goitre was made and hemithyroidectomy was performed and specimen sent for histopathology. The case on histopathology was diagnosed as papillary microcarcinoma in multinodular goiter with lymphocytic thyroiditis which was further confirmed by immunohistochemistry. Recent studies have suggested that the micro-carcinomas classically progress to a clinically evident disease if left untreated. The treatment of papillary microcarcinoma should be similar to papillary thyroid cancer.

Keywords

• Multi Nodular Goitre
• Papillary microcarcinoma Carcinoma
• Lymphocytic Thyoiditis