Diagnosis and treatment of a rare bilateral primary thyroid cancer: a case report
Preoperative ultrasound examination of thyroid nodules is the most economical and effective screening method for diagnosing thyroid nodules. Fine-needle aspiration biopsy (FNAB) cytology guided by ultrasound has high sensitivity and specificity in distinguishing benign and malignant thyroid nodules....
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Frontiers Media S.A.
2025-02-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2024.1468550/full |
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| author | Hai Lin Xinyu Zhang Na Yan Tao Guo Qiu Chen Xianen Huang Dandan Wang Weili Wu |
| author_facet | Hai Lin Xinyu Zhang Na Yan Tao Guo Qiu Chen Xianen Huang Dandan Wang Weili Wu |
| author_sort | Hai Lin |
| collection | DOAJ |
| description | Preoperative ultrasound examination of thyroid nodules is the most economical and effective screening method for diagnosing thyroid nodules. Fine-needle aspiration biopsy (FNAB) cytology guided by ultrasound has high sensitivity and specificity in distinguishing benign and malignant thyroid nodules. However, approximately 25% of thyroid nodules cannot be determined by FNAB, and accurate differentiation of benign and malignant thyroid nodules is critical for patient prognosis. Here, we report the diagnosis and surgical treatment process of a rare patient with bilateral thyroid malignant tumor of independent origin. This patient had significantly elevated levels of calcitonin (Ctn: 130.00 pg/mL) and carcinoembryonic antigen (CEA: 16.13 ng/mL). Ultrasound shows a solid nodule on the left side of the thyroid gland, measuring 1.2*0.8*0.9cm, TI-RADS 4A; right solid nodule, 1.3*0.7*0.9 cm, TI-RADS 3. A fine needle biopsy of the left nodule showed little glandular epithelium and no evidence of malignancy. Multi-gene joint analysis of RET C634R in the left nodule and BRAF V600E in the right nodule indicated a potential diagnosis of left medullary thyroid carcinoma (MTC) and right papillary thyroid carcinoma (PTC). Postoperative pathology revealed the left thyroid nodule was MTC and the right nodule was PTC. The patient’s bilateral thyroid nodules are independent primary malignant lesions. This case emphasizes the important significance of combined analysis of ultrasound, serum biomarkers, cellular pathology, molecular detection, and paraffin pathology in the differential diagnosis of benign and malignant multiple thyroid nodules. It provides a reference for future diagnosis and treatment decisions of multiple thyroid nodules. |
| format | Article |
| id | doaj-art-9f83da3b2eb346e8b107ebc2a29fcaf5 |
| institution | DOAJ |
| issn | 2234-943X |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj-art-9f83da3b2eb346e8b107ebc2a29fcaf52025-08-20T03:11:33ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-02-011410.3389/fonc.2024.14685501468550Diagnosis and treatment of a rare bilateral primary thyroid cancer: a case reportHai Lin0Xinyu Zhang1Na Yan2Tao Guo3Qiu Chen4Xianen Huang5Dandan Wang6Weili Wu7Department of Endocrinology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, ChinaWenzhou Medical University Renji College, Wenzhou, Zhejiang, ChinaKey Laboratory of Digital Technology in Medical Diagnostics of Zhejiang Province, Hangzhou, Zhejiang, ChinaKey Laboratory of Digital Technology in Medical Diagnostics of Zhejiang Province, Hangzhou, Zhejiang, ChinaDepartment of Endocrinology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, ChinaDepartment of Endocrinology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, ChinaDepartment of Traditional Chinese Medicine Orthopedics and Traumatology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, ChinaDepartment of Thyroid and Breast Surgery, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, ChinaPreoperative ultrasound examination of thyroid nodules is the most economical and effective screening method for diagnosing thyroid nodules. Fine-needle aspiration biopsy (FNAB) cytology guided by ultrasound has high sensitivity and specificity in distinguishing benign and malignant thyroid nodules. However, approximately 25% of thyroid nodules cannot be determined by FNAB, and accurate differentiation of benign and malignant thyroid nodules is critical for patient prognosis. Here, we report the diagnosis and surgical treatment process of a rare patient with bilateral thyroid malignant tumor of independent origin. This patient had significantly elevated levels of calcitonin (Ctn: 130.00 pg/mL) and carcinoembryonic antigen (CEA: 16.13 ng/mL). Ultrasound shows a solid nodule on the left side of the thyroid gland, measuring 1.2*0.8*0.9cm, TI-RADS 4A; right solid nodule, 1.3*0.7*0.9 cm, TI-RADS 3. A fine needle biopsy of the left nodule showed little glandular epithelium and no evidence of malignancy. Multi-gene joint analysis of RET C634R in the left nodule and BRAF V600E in the right nodule indicated a potential diagnosis of left medullary thyroid carcinoma (MTC) and right papillary thyroid carcinoma (PTC). Postoperative pathology revealed the left thyroid nodule was MTC and the right nodule was PTC. The patient’s bilateral thyroid nodules are independent primary malignant lesions. This case emphasizes the important significance of combined analysis of ultrasound, serum biomarkers, cellular pathology, molecular detection, and paraffin pathology in the differential diagnosis of benign and malignant multiple thyroid nodules. It provides a reference for future diagnosis and treatment decisions of multiple thyroid nodules.https://www.frontiersin.org/articles/10.3389/fonc.2024.1468550/fullmultiple thyroid nodulesPTCMTCmolecular assisted diagnosiscase report |
| spellingShingle | Hai Lin Xinyu Zhang Na Yan Tao Guo Qiu Chen Xianen Huang Dandan Wang Weili Wu Diagnosis and treatment of a rare bilateral primary thyroid cancer: a case report Frontiers in Oncology multiple thyroid nodules PTC MTC molecular assisted diagnosis case report |
| title | Diagnosis and treatment of a rare bilateral primary thyroid cancer: a case report |
| title_full | Diagnosis and treatment of a rare bilateral primary thyroid cancer: a case report |
| title_fullStr | Diagnosis and treatment of a rare bilateral primary thyroid cancer: a case report |
| title_full_unstemmed | Diagnosis and treatment of a rare bilateral primary thyroid cancer: a case report |
| title_short | Diagnosis and treatment of a rare bilateral primary thyroid cancer: a case report |
| title_sort | diagnosis and treatment of a rare bilateral primary thyroid cancer a case report |
| topic | multiple thyroid nodules PTC MTC molecular assisted diagnosis case report |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2024.1468550/full |
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