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Oxyphilic adenoma - Case 15.

Nodular goiter

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Clinical presentation: a 23-year-old woman was referred for hypothyroidism known for 4 years.

Functional state: hypothyroidism (TSH 10.6 mIU/L) on daily 75 microgram levo-tiroxine.

Ultrasonography: moderately hypoechogenic lobes with a nodule-like lesion in the right lobe.

Cytological report: Hürthle-cell tumor or medullary cancer.

S erum-calcitonin determination: which yielded normal result.

Histopathological diagnosis: Hürthle-cell adenoma.

Comment:

  1. The atypia observed in oxyphilic adenoma may be more pronounced that in well-differentiated thyroid tumor.

  2. In this case, the clear cytological distinction between a Hürthle-cell tumor and medullary cancer is very difficult. The lack of significant number of follicles and that of prominent nucleoli combined with the presence of polygonal cells with eccentric nuclei raised the possibility of medullary cancer.

  3. Taking the sonographic pattern into account, the risk of a medullary cancer is very low.

 

 

 

 

 

 

 

 

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