Abstract

Objectives: Thyroid cancers can be mulifocal. Synchronous occurance of multiple primary cancers in the same patient is a rare event. Some case reports have been published in the literature about multiple primary thyroid cancers. Occurance of multiple primary thyroid cancers in patients with thyroid autoimmunity is even rarer. Herein we present a case report of a patient with hashimoto’s thyroiditis developing follicular thyroid cancer (FTC) in the right lobe and papillary thyroid cancer (PTC)in the left lobe.
Case: A 49 year old female patient followed up with diagnosis of type 2 diabetes and hypothyroidism underwent total thyroidectomy due to having dysphagia and after ultrasonogaphy revealed multiple nodules in both lobes coalescent in character with maximum diametres ranging from 15 to 40mm. The pathology report revealed a 4.5cm follicular neoplasm on the right lobe, a 1mm papillary neoplasm on the left lobe and lymphocytic infiltration compatible with Hashimoto’s thyroiditis. She received 100 millicuries of radioactive iodide treatment and is being folliowed up under remission.
Discussion: Common follicular cell histology of PTC and FTC and the probable relationships of hashimoto’s thyroiditis and diabetes with thyroid cancers may bring an explanation to this case. More experience with cases having multiple primary thyroid cancers are needed to explain the exact pathogenesis.