Case Reports

Simultaneous occurrence of papillary and medullary thyroid carcinoma in a 25-year-old female patient: a case study

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Abstract

Introduction. This study presents a rare case of a patient with simultaneously present papillary and medullary thyroid carcinomas. 
Case report. A 25-year-old female patient with a simultaneous occurrence of papillary and medullary thyroid carcinoma and a positive family history of benign thyroid illness was presented. Our patient presented with non-specific symptoms, which led her to consult her family physician. The patient had undergone a complete thyroidectomy only three weeks after her first doctor’s appointment since her family physician quickly and correctly presumed thyroid disease. The patient had two operations. During the first surgery, a total thyroidectomy was performed, and 19 regional lymph nodes were removed, two of which were positive for papillary and two for medullary carcinoma. Histopathological examination revealed papillary carcinoma in the left lobe and medullary carcinoma in the right lobe of the thyroid gland. Following the aforementioned surgery, the papillary carcinoma was treated with radioactive iodine, while the medullary carcinoma was treated surgically. Given the high calcitonin levels after thyroidectomy, a several months later new surgery was performed to remove the lymph nodes of the neck (four of nine lymph nodes were positive for medullary carcinoma). RET proto-oncogene test results were negative. The patient had no known risk factors for the development of a malignant disease. 
Conclusion. The patient is feeling well two years after diagnosis and complete thyroidectomy, while on her regular checkups, no metastases have been found. 

Keywords: papillary thyroid carcinoma, medullary thyroid carcinoma, simultaneously present

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