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Poorly differentiated thyroid carcinoma probably arising from a papillary thyroid carcinoma: a report of an uncommon entity

SeifeddineBen Hammouda, Nouha Ben Abdeljelil, Manel Njima, Ahlem Bellalah, Abdelfattah Zakhama and Amel El Korbi and Rim Hadhri

Poorly differentiated thyroid carcinoma (PDTC) is a rare thyroid cancer histotype, with a reported incidence from 2 to 15% of all thyroid malignancies. It represents a heterogeneous group that lies intermediately between well‑differentiated thyroid carcinoma (WDTC) and anaplastic thyroid carcinoma (ATC). Most of the PDTC develop de novo while some of them arisefrom preexisting follicular or papillary carcinoma or from pre-existing nodular goiter.
We hereby report a case of PDTCprobably arising from a papillary thyroid carcinoma, in a 60‑year‑old female presenting with anterior neck swelling and pain for two months. On examination, the patient had anterior baseline neck swelling, which was non tender, hard in consistency and measuring 8 cm. Computed Tomography scan (CT) showed multinodular and heterogeneous aspect of the right thyroid lobe with suspect ipsilateral cervical lymphadenopathy and thrombosis of the internal jugular vein. Lymph node biopsy showed a massive lymph node metastasis of carcinoma other than papillary thyroid carcinoma.
The decision was to perform subtotal thyroidectomy followed by completion thyroidectomy and radical neck dissection. The diagnosis of PDTCarising from a papillary thyroid carcinomawas made.
PDTC is a heterogeneous group of follicular cell thyroid cancers that has a diagnostic challenge due to its rarity and ambiguous diagnostic criteria. This case support literature data concerning PDTC etiologies.

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