Thyroid Carcinoma on the Side of the Absent Lobe in a Patient with Thyroid Hemiagenesis

Abstract

Background Thyroid carcinoma complicated by hemiagenesis is very rare, and previous reports have not described this cancer on the side of the absent lobe. Methods and Results We report the case of a 64-year-old woman in whom left thyroid hemiagenesis was discovered incidentally during investigations of abnormal sensation during swallowing. A tumorous 1.4 cm lesion was also found on the side of the absent lobe, left of the isthmus. Fine-needle aspiration biopsy revealed class V papillary carcinoma, but no lymph node metastases. Total thyroidectomy was performed for stage cT1bN0M0 carcinoma. Histopathology revealed normal thyroid tissues in the right lobe and isthmus, while the left lobe was absent. The mostly papillary carcinoma was adjacent to the truncated thyroid tissue, with a portion histologically consistent with poorly differentiated carcinoma. Conclusions All previously reported cases of thyroid cancer complicated by hemiagenesis have represented carcinoma occurring within the present lobe. This case is extremely rare.

Thyroid hemiagenesis with primary hyperparathyroidism or papillary thyroid carcinoma: A report of two cases and literature review

“…So far, 19 cases have been documented in the PubMed-indexed literature (Table 2). 2,7,8,11,[20][21][22][23][24][25][26][27][28][29][30][31][32][33] The ages of patients ranged from 14 to 74 years. Only three patients were males (16%), while the majority were females (n = 16, 84%).…”

“…TH exhibits gender propensity for female predominance, and the left thyroid lobe is most commonly affected. 1,2 TH is believed to be an exceptionally unusual developmental anomaly with an estimated prevalence of 0.02%-0.2%. 2 Usually, TH is detected incidentally during routine screening or workup of other thyroid diseases.…”

“…1,2 TH is believed to be an exceptionally unusual developmental anomaly with an estimated prevalence of 0.02%-0.2%. 2 Usually, TH is detected incidentally during routine screening or workup of other thyroid diseases. The underlying etiology of this anomaly is unknown; however, genetic factors may play a role in such pathogenesis.…”

“…Thyroid hemiagenesis (TH) is the failed embryological development of one thyroid lobe. TH exhibits gender propensity for female predominance, and the left thyroid lobe is most commonly affected 1,2 . TH is believed to be an exceptionally unusual developmental anomaly with an estimated prevalence of 0.02%‐0.2% 2 .…”

Thyroid hemiagenesis is combined with a variety of thyroid disorders

“…16 cases of thyroid malignancy in patients with TH have so far been reported in the literature so far. (22,23,40,43,48,52). Papillary carcinoma was the most common histology in 11 cases, one case of follicular carcinoma, one of medullary carcinoma, one of combined papillary and follicular carcinoma ,one of poorly differentiated carcinoma on the side of the absent thyroid and one case of differentiated thyroid cancer associated with Graves'disease (8,43).…”