Thyroid Hemiagenesis and Papillary Carcinoma: a Rare Association
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CASE REPORT
Thyroid Hemiagenesis and Papillary Carcinoma: a Rare Association Sowjanya Gandla 1 & Rajshekar Halkud 1 & K. T. Siddappa 1 & Samskruthi P. Murthy 1 & Sree lekha Ray 2 & Samriddhi 1 & P. Greeshma 1 Received: 16 November 2019 / Accepted: 1 April 2020 # Indian Association of Surgical Oncology 2020
Abstract A 20-year-old female presented with a slowly growing solitary left thyroid nodule for 1 year. USG and CECT neck showed a 4 × 3 cm solid-cystic nodule in the left lobe of thyroid, with notable absence of the right lobe. FNAC from the nodule was Bethesda V. Operative findings confirmed right thyroid lobe agenesis with corresponding absence of right superior thyroid vessels. The right sided RLN, ESBLN, superior and inferior parathyroids, and inferior thyroid vasculature were in their anatomical positions. She underwent standard left hemithyroidectomy. Histopathological examination revealed follicular variant of papillary carcinoma. Keywords Thyroid hemiagenesis . Papillary thyroid carcinoma
Introduction Thyroid hemiagenesis is a very rare congenital anomaly, in which one lobe of the thyroid fails to develop. Thyroid hemiagenesis is commonly seen in the left lobe (4:1) [1]. The true incidence of thyroid hemiagenesis is not known because most of them are asymptomatic [2]. The prevalence of thyroid hemiagenesis ranges between 0.025 and 0.05%1. Since 1866, only 300 cases of thyroid hemiagenesis have been reported worldwide, of which 13 cases have reported a malignancy. The co-occurrence of thyroid hemiagenesis and carcinoma in the other lobe is extremely rare [3, 4]. Here we describe a rare presentation of a right thyroid lobe hemiagenesis and follicular variant of papillary carcinoma thyroid in the remnant left lobe.
Case Report A 20-year-old female presented to our outpatient department with a left side thyroid swelling of 1 year duration. The swelling was insidious in onset and gradually progressive. There * Sowjanya Gandla [email protected] 1
Department of Head and Neck Surgery, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
2
Consultant Head and Neck Oncusurgery, Deenanath Mangeshkar Hospital, Pune, India
was no other significant medical or surgical history. The physical examination showed 4 × 3 cm solitary, nontender, and firm nodule present in the left lobe of thyroid which moved with deglutition. There was no abnormality noted on the right side, and there are no other swellings palpable in the neck. Oral cavity, oropharyngeal, and laryngeal examination were normal with mobile vocal cords. Ultrasonography of the neck revealed 4 × 3 cm hypoechoic, solid nodule in the left lobe of thyroid; however, the right lobe of the thyroid was not seen and no enlarged lymph nodes present in the neck. Computed tomography of neck confirmed the ultrasound findings (Fig. 1). Once the diagnosis of hemiagenesis was confirmed, CT scan was reviewed for ectopic thyroid rests and neck nodes. Since it was negative, nuclear scan was not performed. Fine needle aspiration cytology of the left thyroid
