Vol.98No.9contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 98 No. 9 September 2005
Autonomously Functioning Thyroid Nodule with Papillary
Microcarcinoma and Lymph Node Metastasis: A Case Report
Kaori Kayano
(Rakuwakai Marutamachi Hospital)
Yasushi Murakami
(Kyoto Local Medical Interdisciplinary Research Institute)
We report a case of autonomously functioning thyroid nodule (AFTN) with papillary microcarcinoma in a 74-year-old woman. She complained of a right anterior neck mass, and presented with hyperthyroidism. Computed tomography and magnetic resonance imaging of the thyroid showed a nodule measuring 2.5×2 cm in the right lobe and a nodule measuring 5×4.5 cm in the left lobe. The left lobe nodule was hyperfunctioning on Tc-99m imaging. On the other hand, the right lobe nodule showed uptake on delayed Tl-201 imaging and was suggested to be malignant. Fine needle aspiration biopsy using ultrasonography was class V (papillary carcinoma) for the right lobe nodule and class II for the left lobe nodule. The patient underwent total thyroidectomy and right regional neck dissection. Histopathological examination revealed two papillary microcarcinomas (each 5 mm in diameter) surrounded by nodular hyperplasia in the right lobe, nodular hyperplasia in the left lobe, and right pretracheal and paratracheal lymph node metastasis. Since it is not rare for cancer to be associated with AFTN, care must be taken to obtain an accurate diagnosis in such cases and surgery is the treatment of choice for AFTN.
Key words : autonomously functioning thyroid nodule (AFTN), papillary micro carcinoma, lymph node metastasis