Clinical Research Of Rare Thyroid Tumors With2Case Reports

ObjectiveThis study aimed to diagnose special types of thyroid tumors (such as primary thyroid paraganglioma, thyroid nodules with lymphatic tuberculosis) distinguishing with thyroid carcinoma through comprehensive analysis of clinical symptoms, physical examination, image and pathology examinations, so as to improve the levels of recognition, diagnosis and treatment.Methods and ResultsThe First Part:Primary thyroid paraganglioma (TP) is an uncommon tumor. In unusual cases, this disease tends to mimic medullary thyroid carcinoma (MTC). The present study reports a rare case of primary TP accompanied by hyperthyroidism status mimicking thyroid carcinoma. A30-year-old female was found an anterior cervical mass. Pre-operative radiological studies and operative frozen section analysis indicated untypical MTC. Finally primary TP was diagnosed with the help of pathology and immunohistochemistry staining. Laboratory examinations and emission computed tomography revealed hyperthyroidism. Gene analysis of TP relative gene mutation was negative. Surgical resection is a curative approach and there is no metastasis after36months follow-up.The Second Part:It is to report a case of thyroid nodules with ipsilateral neck lymphatic tuberculosis mimics the presentation of thyroid cancer with neck lymph node metastasis through ultrasound examination. A25-year-old female was found enlarged lymph node in the left neck. Ultrasound examination suspects thyroid cancer with ipsilateral neck lymph node metastasis, so is plan to perform the operation of left lobe+isthmus thyroidectomy and left neck lymphadenectomy. During the operation, it was diagnosed as nodular goiters through frozen section examination. So a biopsy of lymph nodes was performed in V area of the left neck. Post-operation, neck lymphatic tuberculosis was finally diagnosed by the examination of pathology and acid-fast staining. After regular antituberculous treatment, the patient recovered and no relapsed during the12-month follow-up.ConclusionsThe First Part:Surgeons must be aware of primary TP, especially distinguished with MTC, in order to ensure correct diagnosis and to prevent performing unnecessary procedures. Immunohistochemistry staining is necessary in diagnosing primary TP, and hemithyroidectomy is appropriate in curing this disease.The Second Part:Neck lymphatic tuberculosis is not rare in the clinical works. However, because lacking of effective auxiliary examinations and much clinical experience, it is easily to cause misdiagnosis and mistreatment. If neck lymphatic tuberculosis accompanies with nodular goiter, it is likely to show the presentation of thyroid cancer with lymph node metastasis in ultrasound examination. Pre-operation cervical lymph node aspiration or biopsy may be an effective method in making differential diagnoses. Antituberculous is the main approach in treating with cervical lymphatic tuberculosis, and the prognosis is favourable.