Korean J Endocr Surg.  2015 Mar;15(1):15-19. 10.16956/kaes.2015.15.1.15.

Cystic Medullary Thyroid Carcinoma: A Case of Undergoing Endoscopic Thyroid Lobectomy

• Chung DH
• Seok JY
• Chung YS
• Oh EM
• Ryu JW
• Lee YD

• KMID: 2144009
• DOI: http://doi.org/10.16956/kaes.2015.15.1.15

Abstract

On ultrasonography, medullary thyroid carcinoma (MTC) shows hypoechogenicity, an irregular margin, a predominantly solid composition, and microcalcifications, similar to those observed in papillary thyroid carcinoma (PTC). MTC presenting as a cystic lesion is rare, and endoscopic thyroidectomy can be performed for benign thyroid masses and early stage PTC, however it is inappropriate for MTC regardless of cystic change. The authors report a case of cystic MTC found after endoscopic thyroid lobectomy and provide a review of the literature on this topic.

Keyword

Medullary thyroid carcinoma; Thyroid cyst; Endoscopic thyroidectomy

MeSH Terms

Thyroid Gland*
Thyroid Neoplasms*
Thyroidectomy
Ultrasonography

Figure

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  Fig. 1. Transverse (A) and longitudinal (B) ultrasonographic views showing a 3.51×2.75×5.26 cm sized hypoechoic predominantly cystic lesion with incomplete septa occupying the entire left thyroid gland.

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  Fig. 2. Left thyroid gland was easily separated from strap muscle during endoscopic thyroidectomy using BABA. On palpation, the left thyroid gland was soft and smooth after removal using an endoscopic plastic bag via a right areolar incision.

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  Fig. 3. Photographs of medullary thyroid carcinoma showing prominent cystic change. (A) Low power view showing a large cystic space in the center and in the solid portion at the periphery of the tumor (H&E, ×10). (B) In the solid portion, cystic change with hemorrhage and aggregation of hemosiderin-laden macrophages was noted (H&E, ×100). (C) High power view showing solid sheets of uniform tumor cells. Note the prominent vasculature and focal amyloid deposition (arrow) (H&E ×400). (D) Tumor cells were positive for calcitonin (immunostain, ×400).

Reference

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