Subacute Thyroiditis With Coexisting Papillary Carcinoma Diagnosed by Immediately Repeat Fine Needle Aspiration: A Case Report

Abstract

Subacute granulomatous thyroiditis (SAT) is a spontaneously remitting inflammatory disease that is probably caused by viral infection. It has typical findings on ultrasound (US) which consist of focal ill-defined hypoechoic areas and no vascular flow in the hypoechoic areas on Doppler ultrasound. Papillary thyroid carcinoma is the most common type of thyroid cancer, and is often detected incidentally on US. However, SAT with coexisting papillary carcinoma is very rare. We report a case of SAT with coexisting papillary carcinoma diagnosed by immediate repeat US-guided fine needle aspiration (FNA). A 44-year-old woman was referred to our center for FNA of a thyroid nodule. She had anterior neck pain beginning 2 months prior to presentation and was treated at a local medical clinic. The thyroid US demonstrated a 1.2 x 0.8 cm nodule in the left lobe of the thyroid and ill-defined hypoechoic areas in both lobes of the thyroid. We performed US-guided FNA on that lesion. One week later, the cytology report was benign. Therefore, we performed repeat aspiration, which revealed papillary thyroid carcinoma. Total thyroidectomy was performed along with dissection of the central compartment of the neck and the nodule was confirmed to be papillary carcinoma without lymph node metastasis. The other portion of the thyroid showed the typical pathologic features of SAT.




J Med Cases. 2012;3(5):308-311
doi: https://doi.org/10.4021/jmc665w