Published online Mar 6, 2019. doi: 10.12998/wjcc.v7.i5.656
Peer-review started: January 22, 2019
First decision: January 26, 2019
Revised: February 1, 2019
Accepted: February 18, 2019
Article in press: February 18, 2019
Published online: March 6, 2019
Paraganglioma/pheochromocytoma and medullary thyroid carcinoma can coexist and are often found in multiple endocrine neoplasia (MEN). However, very few cases highlight papillary thyroid carcinoma. We present herein a rare case of head and neck paraganglioma associated with papillary thyroid carcinoma.
A 51-year-old man presented to our department with right-sided neck swelling and hypertension. Physical examination showed neck masses with obvious pulsation. Concentrations of serum calcium, phosphorus, parathormone, thyroid stimulating hormone, free thyroxine, and calcitonin were within normal limits. Enhanced computed tomography revealed an irregular solid nodule, located in the carotid artery bifurcation. A low-density nodule of the thyroid isthmus with a spot-like dense shadow was also detected. The diagnosis of carotid body tumor was raised and an ultrasound-guided fine needle aspiration biopsy of the thyroid nodule revealed papillary thyroid carcinoma. The patient underwent surgery for lesion excision, total thyroidectomy, and neck dissection, and the pathology was reported as paraganglioma and papillary carcinoma. Genetic studies showed negative results for germline mutation of succinate dehydrogenase subunit D on 11q23. He was treated with 131I after surgery and remained disease-free so far.
The presence of concomitant paraganglioma and thyroid papillary carcinoma could be either coincidental or a result of an unknown mutation.
Core tip: The presence of concomitant paraganglioma and thyroid papillary carcinoma is extremely rare. We present a case of a head and neck paraganglioma associated with papillary thyroid carcinoma in a 51-year-old man. The major characteristics and imaging features of the lesion are discussed.