Tziona EE, Emmanouilidou A, Stouras I, Omar CT, Koloka M, Savva A, Dimitrakopoulou K, Iosifidis G, Pazaitou-Panayiotou K, Michalopoulos N. Thyroid carcinoma of the pyramidal lobe: A narrative review of reported cases. World J Clin Cases 2026; 14(10): 118950 [DOI: 10.12998/wjcc.v14.i10.118950]
Corresponding Author of This Article
Angeliki Emmanouilidou, Researcher, Department of Endocrine Surgery, Genesis Hospital, End of 17th Noemvri St, Pylaia, Thessaloniki 55535, Greece. emmaange@auth.gr
Research Domain of This Article
Surgery
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Minireviews
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
Apr 6, 2026 (publication date) through Apr 5, 2026
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Publication Name
World Journal of Clinical Cases
ISSN
2307-8960
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Tziona EE, Emmanouilidou A, Stouras I, Omar CT, Koloka M, Savva A, Dimitrakopoulou K, Iosifidis G, Pazaitou-Panayiotou K, Michalopoulos N. Thyroid carcinoma of the pyramidal lobe: A narrative review of reported cases. World J Clin Cases 2026; 14(10): 118950 [DOI: 10.12998/wjcc.v14.i10.118950]
Eleni Evdoxia Tziona, Angeliki Emmanouilidou, Chrysanthi Tzenin Omar, Marina Koloka, Artemis Savva, Konstantina Dimitrakopoulou, Grigoris Iosifidis, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
Angeliki Emmanouilidou, Nickos Michalopoulos, Department of Endocrine Surgery, Genesis Hospital, Thessaloniki 55535, Greece
Ioannis Stouras, School of Medicine, National and Kapodistrian University of Athens, Athens 11527, Greece
Kalliopi Pazaitou-Panayiotou, Department of Endocrinology-Endocrine Oncology, European Interbalkan Medical Center, Thessaloniki 57001, Greece
Co-first authors: Eleni Evdoxia Tziona and Angeliki Emmanouilidou.
Author contributions: Emmanouilidou A and Michalopoulos N conceptualized the study; Tziona EE, Stouras I, Omar CT, Savva A, Koloka M, Dimitrakopoulou K and Iosifidis G contributed to the resources; Emmanouilidou A, Tziona EE contributed to the data curation; Emmanouilidou A, Tziona EE, Stouras I, Omar CT, Savva A, Koloka M, Dimitrakopoulou K and Iosifidis G wrote the original draft; Emmanouilidou A, Tziona EE and Stouras I wrote the review and edited the manuscript; Pazaitou-Panayiotou K and Michalopoulos N supervised the study; Emmanouilidou A and Tziona EE have made crucial and indispensable contributions towards the completion of the project and thus qualified as the co-first authors of the paper.
Conflict-of-interest statement: The authors declare no conflict of interests for this article.
Corresponding author: Angeliki Emmanouilidou, Researcher, Department of Endocrine Surgery, Genesis Hospital, End of 17th Noemvri St, Pylaia, Thessaloniki 55535, Greece. emmaange@auth.gr
Received: January 15, 2026 Revised: February 14, 2026 Accepted: March 10, 2026 Published online: April 6, 2026 Processing time: 77 Days and 17.1 Hours
Abstract
Papillary thyroid carcinoma arising from the pyramidal lobe is a rare entity that poses diagnostic and therapeutic challenges, as this anatomical structure is frequently overlooked during preoperative assessment and thyroid surgery, potentially compromising oncological outcomes. A narrative review of the literature identified 38 reported cases of pyramidal lobe thyroid carcinoma, of which 29 cases, including one additional illustrative case, met predefined inclusion criteria and were analyzed. Extracted data included demographic characteristics, clinical presentation, thyroid function, imaging and biopsy methods, operative management, histopathological findings, tumor multifocality, extrathyroidal extension, tumor-node-metastasis staging, adjuvant treatment, and follow-up. Most tumors were papillary carcinomas occurring predominantly in female patients, commonly presenting as anterior neck masses with preserved thyroid function. Ultrasound and computed tomography were the most frequently utilized imaging modalities, while fine-needle aspiration was the primary diagnostic tool. Surgery most often involved total thyroidectomy with central or combined central and lateral neck dissections. Multifocality and extrathyroidal extension were reported in a substantial proportion of cases. Follow-up data were limited, with no documented recurrences among reported cases. Awareness of the pyramidal lobe as a potential primary site of thyroid carcinoma and its complete surgical excision are essential for optimal oncological management.
Core Tip: Thyroid carcinoma arising from the pyramidal lobe is an uncommon but clinically significant entity. This review synthesizes all reported cases to date and highlights key diagnostic challenges, patterns of lymphatic spread, and surgical considerations unique to pyramidal lobe malignancies. By integrating a rare illustrative case with a comprehensive narrative review, this article underscores unresolved issues in detection and management, emphasizes the oncologic importance of complete pyramidal lobe excision, and outlines directions for improving preoperative assessment and long-term disease control.
