Abstract

D'ADDINO, JL; PIGNI, MM; SIGUELBOIM, D  and  NIEPOMNISZCZE, H. Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma. Rev. argent. endocrinol. metab. [online]. 2012, vol.49, n.2. ISSN 1851-3034.

Objective: To report a case of a diffuse sclerosing papillary carcinoma, a rare type of thyroid carcinoma, of difficult diagnosis, its management and further follow-up. Case: 37-year-old white male who presented with a 6-month history of sudden onset of an asymptomatic right-sided lateral cervical lump. No relevant previous medical or family history. On ultrasound, thyroid nodule, heterogeneous thyroid. A fine needle aspiration of a regional node was reported as adenocarcinoma and that of the thyroid nodule as a colloid cyst. Right radical neck dissection was performed. The intra-operatory biopsy revealed thyroid carcinoma; therefore, left neck dissection and total thyroidectomy were undertaken. Histopathology reported "diffuse sclerosing papillary carcinoma with metastasis to 5 of 6 right perithyroid lymph nodes and to 7 of 9 cervical lymph nodes, 4 on the right and 3 on the left. Stage: I, T3-N1b-M0". The patient received 3 doses of iodine 131 as well as external radiotherapy due to mediastinal mass. Follow-up at 6 months (to present) reveals he remains disease free. Thyroid gland enlargement and an increased prevalence of nodules is observed in subjects with insulin resistance and metabolic syndrome. Insulin and TSH are growth factors for thyroid cells, and TSH levels are higher in people with metabolic syndrome, present in this patient. Conclusion: The diffuse sclerosing carcinoma is a rare tumour of uncertain origin, with aggressive behavior, early extrathyroid invasion and distant metastasis. No financial conflicts of interest exist.

Keywords : Diffuse sclerosing papillary thyroid carcinoma.

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