Papillary thyroid carcinoma presenting as miliary nodules on chest roentgenogram in the paediatric setting: A case report.
Endocrine pathology
Lymphangitic carcinomatosis
Papillary thyroid carcinoma
Journal
International journal of surgery case reports
ISSN: 2210-2612
Titre abrégé: Int J Surg Case Rep
Pays: Netherlands
ID NLM: 101529872
Informations de publication
Date de publication:
2020
2020
Historique:
received:
29
05
2020
revised:
09
06
2020
accepted:
10
06
2020
pubmed:
21
6
2020
medline:
21
6
2020
entrez:
21
6
2020
Statut:
ppublish
Résumé
Papillary thyroid carcinoma (PTC) is the most common carcinoma to occur in childhood with a peak incidence between 11-17 years, and typically presents with advanced locoregional disease. Pulmonary metastases are seen in up to 46% of cases and should enter the differential diagnosis of miliary nodules seen on chest roentgenogram, even in regions where tuberculosis is endemic. An 11-year-old male presented with a short history of cough, shortness of breath and constitutional symptoms. Examination revealed cervical lymphadenopathy and diffuse bilateral nodular infiltrates on the chest roentgenogram. Investigation for Mycobacterium tuberculosis was negative and this initiated biopsy of a cervical lymph node. Histopathological examination revealed metastatic PTC. Ultrasonography and magnetic resonance imaging (MRI) were performed for preoperative staging. The patient subsequently underwent total thyroidectomy with selective neck dissection. There are several potential causes when dealing with miliary nodules on chest roentgenogram. Thorough interrogation of the clinical, radiological, pathological and microbiological data is required to arrive at the correct diagnosis. Postoperative adjuvant therapy with radioactive iodine is recommended in children with metastatic disease, but this should be restricted preferably to a single dose to avoid the complication of pulmonary fibrosis. This case highlights the differential diagnostic considerations of a patient presenting with constitutional symptoms and a miliary pattern on chest roentgenogram. Carcinomas are uncommon in children but should not be forgotten.
Identifiants
pubmed: 32563095
pii: S2210-2612(20)30461-2
doi: 10.1016/j.ijscr.2020.06.058
pmc: PMC7305368
pii:
doi:
Types de publication
Case Reports
Langues
eng
Pagination
322-325Informations de copyright
Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest There authors declare no conflict of interest.
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