An interesting rare case of dual malignancy in a large thyroid- Mixed medullary-follicular carcinoma of thyroid

摘要

Background Mixed medullary-follicular carcinomas (MMFCs) are rare tumors of the thyroid that have morphological and immune-histochemical features of both medullary and follicular neoplasms. There is paucity of such case reported from Asia. Methods A 40 year old female patient presented with complaints of neck swelling for the past 20 years with recent increase in size. The patient was clinically euthyroid with a smooth and firm enlargement of right lobe of thyroid & no neck nodes were palpable. A computed tomography scan showed a large heterogeneous enhancing mass lesion reaching up to thoracic inlet and causing displacement of larynx, trachea, oesophagus & carotid artery. Result The patient underwent total thyroidectomy and made uneventful recovery. The histopathological examination report revealed Mixed Medullary & Follicular Carcinoma. Conclusion MMFC represents a diagnostic challenge on fine needle aspiration cytology as final diagnosis is confirmed only on detailed histopathological analysis. The treatment is primarily surgical.