Case report: exceptionally rapid growth character of hobnail variant of papillary thyroid carcinoma: a report of four cases

Endocrine journal

article

Yasuhiro Ito¹  Mitsuyoshi Hirokawa²  Toshitetsu Hayashi²  Hisashi Ota³  Maki Oshita³  Minoru Kihara¹  Akihiro Miya¹  Akira Miyauchi¹ 

[1] Department of Surgery, Kuma Hospital;Department of Diagnostic Pathology, Kuma Hospital;Department of Clinical Laboratory, Kuma Hospital

关键词: Hobnail variant;    Papillary thyroid carcinoma;    Rapid growth;    Recurrence;   

DOI  :  10.1507/endocrj.EJ20-0248

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

The newest WHO classification adopts hobnail variant as an aggressive variant of papillary thyroid carcinoma (PTC). We here report four cases (ages 70–76 years, all females) with hobnail variant PTC treated at Kuma Hospital. Their lesions were cytologically diagnosed as PTC before surgery, but not as hobnail variant. All patients underwent a total thyroidectomy with central node dissection, and two patients also underwent therapeutic lateral node dissection. The clinical courses of three of the patients were very eventful. One patient showed recurrence to lymph nodes in the lateral compartment only 5 months after the initial surgery. In the initial surgery, one patient had a 36-mm lymph node metastasis in the lateral compartment, which was diagnosed as hobnail variant on pathology; 9 months post-surgery, metastases to the ipsilateral lateral lymph node, lung, and bone were newly detected. Her lung metastasis grew rapidly; its tumor volume-doubling time was 0.15 years and its tumor-doubling rate was 6.67/year. One patient underwent annual ultrasound examinations as postoperative follow-up after hemithyroidectomy for a benign nodule, but a 35-mm nodule diagnosed as PTC on cytology and lateral node metastases appeared within a short period, and she underwent a second surgery. Both the primary lesion and lymph nodes were diagnosed as hobnail variant by postoperative pathology. Three of the four patients showed exceptionally rapid growth of primary and/or metastatic/recurred lesions, indicating that patients with the hobnail variant should undergo very close and careful post-operative observation.

【 授权许可】

Unknown