Iranian Journal of Pathology

Papillary Thyroid Carcinoma with Nodular Fasciitis-Like Stroma in a 28-Year-Old Patient

Document Type : Case Reports

Authors

Vahid Zand 1
Mansour Moghimi 2
Elmira Sadeghi 1
Pegah Kamal 2
Sedighe Vaziribozorg 3

1 Department of Otolaryngology-Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

2 Department of Pathology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

3 Department of Otolaryngology- Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

https://doi.org/10.30699/ijp.2022.139405.2525
Abstract
Abstract

Papillary thyroid carcinoma (PTC) is considered as a relatively common type of malignancy showing a wide morphologic spectrum. Different variants of this tumor have been reported. Among PTC variants, PTC with nodular fasciitis-like stroma (PTC‑FLS) is rare. This variant consists of stromal components rich in spindle cells and accounts for 60-80% of tumors. In addition, there are small foci of epithelial components in PTC‑FLS though its features are similar to conventional PTC. In this case study, we present a new case with PTC‑FLS. The case is a 28-year-old female who was referred to the ENT clinic due to a painless mass on the anterior part of her neck. The mass showed a gradual increase in size over the 6 months prior to her referral. Thyroid test results were normal. Ultrasound imaging demonstrated an 84 × 36 mm heterogeneous nodule in the right thyroid lobe without calcifications but increased vascularity. There were also some reactive lymph nodes in both sub-mandibular areas. An ultrasound-guided fine-needle aspiration (FNA) biopsy of the right thyroid lobe nodule revealed a benign thyroid adenomatoid nodule. Following right thyroid lobectomy, final pathologic studies confirmed a diagnosis of PTC with exuberant fibromatosis-like stroma. In the 20-day post-surgery visit, the patient was found asymptomatic. Re-evaluation of the left thyroid lobe and follow-up were recommended. In this study, a diagnosis of a rare variant of PTC, i.e., PTC-FLS, was made through a combination of ultrasonography, fine needle aspiration cytology, and histological examination.

Keywords

Fibromatosis-like stroma
Neck mass
Papillary thyroid carcinoma

Subjects

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Iranian Journal of Pathology
Volume 17, Issue 2
Spring 2022
Pages 225-228

  • Receive Date 11 July 2021
  • Revise Date 08 October 2021
  • Accept Date 25 December 2021

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