Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 6, 2022; 10(10): 3213-3221
Published online Apr 6, 2022. doi: 10.12998/wjcc.v10.i10.3213
Middle thyroid vein tumor thrombus in metastatic papillary thyroid microcarcinoma: A case report and review of literature
Yan Gui, Jun-Yi Wang, Xu-Dong Wei
Yan Gui, Department of Otorhinolaryngology Head and Neck Surgery, The First Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China
Jun-Yi Wang, Department of Thyroid and Neck Tumor, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin 300060, China
Xu-Dong Wei, Department of Otorhinolaryngology Head and Neck Surgery, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China
Author contributions: Gui Y is responsible for reviewing literature and writing article; Wang JY is responsible for surgery and collecting clinical data; Wei XD is responsible for providing overall thinking.
Informed consent statement: Consent from the patient was obtained before publication.
Conflict-of-interest statement: There are no conflicts of interest or funding to disclose concerning this case report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jun-Yi Wang, MD, PhD, Associate Chief Physician, Department of Thyroid and Neck Tumor, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, West Huan-Hu Rd, Ti Yuan Bei, Hexi District, Tianjin 300060, China. jzxsya@163.com
Received: November 3, 2021
Peer-review started: November 3, 2021
First decision: December 27, 2021
Revised: January 7, 2022
Accepted: February 23, 2022
Article in press: February 23, 2022
Published online: April 6, 2022
Processing time: 145 Days and 19.9 Hours
Abstract
BACKGROUND

Although papillary thyroid microcarcinoma (PTMC) is not considered a threatening tumor, in some cases, it can be aggressive. Metastatic thrombosis of papillary thyroid carcinoma, follicular thyroid carcinoma, Hürthle cell carcinoma, poorly differentiated thyroid carcinoma and anaplastic thyroid carcinoma have been reported in the literature, but there have been no reports about PTMC.

CASE SUMMARY

A 45-year-old woman presented with a thyroid mass and thrombosis in a middle thyroid vein during a physical examination. She had no symptoms, and the physical examination showed no positive signs. Subsequent ultrasonography-guided fine-needle aspiration biopsy results indicated an atypical lesion of ambiguous significance, with some actively growing cells (TBSRTC III) and the BRAFV600E mutation not present. This patient underwent left thyroidectomy, isthmus lobectomy, prophylactic central lymph node dissection and thromboembolectomy. Postoperative pathology showed papillary microcarcinoma of the left thyroid, and the thrombus in the middle thyroid vein was a tumor thrombus.

CONCLUSION

Middle thyroid vein tumor thrombus is an extremely rare condition in PTMC, but it does exist. Lobectomy and thromboembolectomy may be an option for patients with thrombi in the middle vein of the thyroid, and we strongly suggest close follow-up of these patients.

Keywords: Thyroid neoplasms; Papillary carcinoma; Thyroid vein; Venous thrombosis; Surgery; Case report

Core Tip: We report the case of a 45-year-old woman presented with a thyroid mass and thrombosis in a middle thyroid vein during a physical examination. This patient underwent left thyroidectomy, isthmus lobectomy, prophylactic central lymph node dissection and thromboembolectomy. Postoperative pathology showed papillary microcarcinoma of the left thyroid, and the thrombus in the middle thyroid vein was a tumor thrombus. Middle thyroid vein tumor thrombus is an extremely rare condition in papillary thyroid microcarcinoma, but it does exist. Lobectomy and thromboembolectomy may be an option for patients with thrombi in the middle vein of the thyroid, and we strongly suggest close follow-up of these patients.