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Hui Jin [1; 2] and Huanhuan Yan [1; 2] and Huamei Tang [3] and Miao Zheng [1; 2] and Chaojie Wu [1; 2] and Jun Liu [1; 2]

Academic Editor: Carlo Capella

1, Shanghai General Hospital of Nanjing Medical University, Shanghai 201620, China, njmu.edu.cn

2, Department of Breast-Thyroid-Vascular Surgery, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai 201620, China, sjtu.edu.cn

3, Pathological Center of School of Medicine, Shanghai Jiaotong University, Shanghai 201620, China, sjtu.edu.cn

Received Oct 9, 2017; Accepted Dec 14, 2017

This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

1. Case Abstract

An 18-year-old female patient was hospitalized due to “a touchable lump on the right of thyroid isthmus” which has been found for about 2 months. The patient has congenital heart disease history and no thyroid disease history in her family. Physical Examination. Bilateral thyroid was slightly swollen. A hard lump about 20 × 10 mm could be touched on thyroid isthmus and could move up and down when swallowing. No vascular murmur could be heard. Laboratory Examination. Routine blood examination and the level of thyroid hormone were normal. B Ultrasound. Echo of thyroid was even, and a low echo tubercle, with size 11 × 20 mm, aspect ratio 0.55, unclear border, and irregular shapes, could be observed on the right side of thyroid isthmus. Multiple dot-like calcification and blood flow signals could be observed (Figure 1(a)). CT Scan. Multiple nodular shadows of lower density could be observed in thyroid and some were calcified with a larger one located in isthmus, about 17 × 10 mm, and the rest were normal (Figure 1(b)). FNA. Cells were arranged closely and overlapped presenting papillary structure. Cell nucleus ditches could be observed (Figure 1(c)). We diagnosed it preoperatively as papillary thyroid carcinoma (PTC). Echocardiography. Congenital heart disease with ventricular septal defect, left to right shunt, and mild pulmonary hypertension.

[figures omitted; refer to PDF]

A hard lump of size 20 × 15 mm and unclear border could be seen on the isthmus of thyroid during surgery. Nanometer carbon tracer was injected into bilateral thyroid to help us to distinguish lymph nodes from parathyroid...

 

 

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