Intrathyroidal Ectopic Thymic Tissue Mimicking Thyroid Cancer in Children |
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| Institution: | 1. Department of Endocrinology, Royal Free Hospital, London, United Kingdom;;2. Department of Cellular Pathology, University College Hospital, London, United Kingdom;;3. Centre for Endocrine Surgery University College Hospital and Great Ormond Street Hospital, London, United Kingdom;;4. Department of Radiology, University College Hospital, London, United Kingdom.;1. Departments of Endocrinology and Diabetes, University Campus Bio-Medico of Rome, Italy;2. Orthopedics, University Campus Bio-Medico of Rome, Italy;3. Hepatology, and Internal Medicine, University Campus Bio-Medico of Rome, Italy, and;5. Centre for Diabetes, The Blizard Building, Barts and The London School of Medicine, Queen Mary, University of London, London, United Kingdom.;1. From the Maryland Endocrine, PA; Columbia, Maryland;2. From the Dexcom, Inc, San Diego, California.;1. From the Endocrinology Department of Internal Medicine, Medical Sciences Faculty, Brazil.;2. From the Clinical and Experimental Research Laboratory on Vascular Biology (BioVasc), Biomedical Center, Brazil.;3. From the Anesthesiology Department of Surgery, Medical Sciences Faculty; State University of Rio de Janeiro, Brazil. |
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| Abstract: | ObjectiveTo increase awareness of the important differential diagnosis between thyroid cancer and intrathyroidal ectopic thymic tissue when performing neck ultrasound (US) in pediatric patients.MethodsWe report 2 cases of intrathyrodal thymic tissue that were initially referred as possible papillary thyroid cancer (PTC). US and cytologic features of these lesions are described, and the distinguishing US characteristics of intrathyroidal thymic tissue versus PTC are discussed.ResultsTwo pediatric patients who underwent thyroid US were diagnosed with thyroid nodules suggestive of PTC. The suspected lesions in both patients exhibited an echo texture identical to the normal thymus gland. Fine-needle aspirate (FNA) biopsy of the nodule in the first case revealed numerous lymphocytes with positive immunocytochemical staining for CD3, confirming a T cell phenotype. The second patient underwent follow-up US imaging 8 months later that showed stability of the intrathyroidal nodule.ConclusionIntrathyroidal ectopic thymic tissue can be mistaken for PTC as both conditions have similar US features. Increased awareness of this unique mimicry may help to avoid unnecessary invasive investigations and surgery in these young patients. (Endocr Pract. 2014;20: e241-e245) |
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