VANISHING PAPILLARY THYROID CARCINOMA: MORPHOLOGICAL CHANGES AFTER FINE-NEEDLE ASPIRATION AACE Clinical Case Reports AACE Clinical Case Rep. 2019;5:e298-e301
Date
09/01/2019Abstract
ABSTRACT
Objective: Fine-needle aspiration (FNA) of a thyroid
nodule is typically considered a benign procedure.
Uncommonly, morphological changes can occur in the
nodule or tissue after the procedure. These changes have
been noted in tissues like thyroid, breast, lymph node,
and prostate. The objective of this case report is to report
the rare occurrence of thyroid cancer diagnosed on FNA,
appearing as a necrotic mass after near total thyroidectomy
and to emphasize the need for confirmation of diagnosis
with histopathology.
Methods: A 69-year-old man was seen for a selfdiscovered
neck mass. Thyroid ultrasound demonstrated
a thyroid nodule with suspicious features. Ultrasoundguided
FNA of the nodule was performed with a 22-gauge
needle without immediate complications.
Results: The cytology was read as consistent with
papillary thyroid cancer with a preoperative thyroglobulin
level of 15,288 ng/mL (normal range is 1.6-55 ng/mL).
After a near total thyroidectomy, histopathology revealed
complete infarction of the tumor with no evidence of
cancerous tissue remaining. Based on the pathology report,
he was considered cured of the cancer and did not receive
radioactive iodine therapy.
Conclusion: The occurrence of tissue infarction
following FNA of a thyroid nodule is rare, reportedly <2%.
We conclude a review of the original cytology material
and a thorough examination of remaining viable tissue be
made. Complete evaluation for invasion of the capsule or
surrounding tissue must be ascertained to decrease diagnostic
errors.
