Journal of Thyroid Disorders & Therapy
Open Access
ISSN: 2167-7948
ISSN: 2167-7948
Antonella Carbone
Endocrine Unit, Asm Matera, Italy
Scientific Tracks Abstracts: Thyroid Disorders Ther
Statement of the problem: Differenziated thyroid carcinomas (DTC), particularly papillary thyroid carcinomas (PTCs), usually have an indolent behavior, howewer 10-20% of the patients develop recurrences, following surgery. There are several histological features associated with more frequent recurrences as the hystopathological variants of PTCs, the presence of vascular invasion or lymph node metastases and the presence of extrathyroidal extension (ETE). Case history: a 56yrs old male patient prevously treated for PTC, with excellent response to the first treatment, presented twelve years after a gradual increase of thyroglobulin (Tg) (from 0.3 to 0.76 ng/ml in 6 months) and a neck lump in the left cervical region at ultrasound imaging. Fine needle aspiration cytology of the mass and Tg measurement in the wash out liquid of the needle was 472 ug/l. Cytology revealed polymorphous epithelial cells with atypical nuclei suggesting metastasis of PTC. Surgery was then performed and pathology showed a massive metastasis in the local adipose tissue and striated muscles of the neck. Genetic analysis of the primary tumor and metastatic tissue revelead a BRAF p. V600E in both primary tumor and in metastatic tissue (37% and 48% respectively). Conclusions: Our patient’s history suggests the need of a continuous and prolonged follow-up in patients with multiple features that increase the recurrence risk ( minimal ETE, size >2 cm, BRAF V600E mutation as in our case).
Antonella Carbone is MD endocrinologist, with clinical experience in diagnosis and management of thyroid diseases. She studied in Naples (“L.Vanvitelli” University) and works from 2006 in Basilicata (South of italy) in the Endocrine Unit of Asm Matera with Rocco Bruno MD. The main field of interest is differentiated thyroid cancer . She is a member of Italian Thyroid Cancer Observatory (ITCO).