Case report: Large follicular thyroid carcinoma with multiple cervical lymph node metastases

Fei Ye; Liyan Liao; Wanlin Tan; Yi Gong; Xiaodu Li; Chengcheng Niu

doi:10.3389/fsurg.2022.995859

Case report: Large follicular thyroid carcinoma with multiple cervical lymph node metastases

Front Surg. 2022 Aug 23:9:995859. doi: 10.3389/fsurg.2022.995859. eCollection 2022.

Authors

Fei Ye¹, Liyan Liao², Wanlin Tan^{3

4}, Yi Gong¹, Xiaodu Li^{3

4}, Chengcheng Niu^{3

4}

Affiliations

¹ Department of Thyroid Surgery, The Second Xiangya Hospital, Central South University, Changsha, China.
² Department of Pathology, The Second Xiangya Hospital, Central South University, Changsha, China.
³ Department of Ultrasound Diagnosis, The Second Xiangya Hospital, Central South University, Changsha, China.
⁴ Research Center of Ultrasonography, The Second Xiangya Hospital, Central South University, Changsha, China.

Abstract

Introduction: Follicular thyroid carcinoma (FTC) rarely metastasizes to regional lymph nodes, as they mainly metastasize through hematogenous route; in particular, a large FTC with only lateral lymph node metastasis and without distant metastasis has rarely been reported.

Case report: We present a 66-year-old male patient with a progressively growing thyroid for more than 20 years, causing tracheal compression and narrowing. Neck ultrasonography, computed tomography (CT), magnetic resonance (MR) imaging and positron emission tomography-computed tomography (PET/CT) were carried out to obtain images of the thyroid and surrounding tissues. Total thyroidectomy and cervical lateral and central lymph node dissection were undertaken, and histopathological, and immunohistochemical evaluations and molecular pathology confirmed the diagnosis of FTC with multiple cervical lymph node metastases.

Conclusion: We have reported a rare case of large FTC with diffuse nodal involvement but no distant metastases. We present the thyroid ultrasound, neck CT, MR and whole body PET/CT.

Keywords: PET/CT; TERT promoter mutation; cervical lymph node metastases; follicular thyroid carcinoma (FTC); thyroid ultrasonography; vascular invasion.

Publication types

Case Reports