Multifocal metastatic papillary thyroid carcinoma: a case report and literature review

Background. Papillary thyroid carcinoma (PTC) is the most common form of malignant tumor of the thyroid gland, accounting for about 1 % of all newly diagnosed malignant neoplasms. The average age of onset for PTC is 50 years, with a predominance of female patients (3 : 1). In most cases, a long course and a favorable prognosis characterize PTC. However, certain pathological features may indicate aggressive metastatic disease. The results of diagnosis and treatment are described in a clinical case of multifocal metastatic PTC. The presence of vascular, extra-organic invasion and metastases necessitate the selection of more aggressive treatment and monitoring. Materials and methods. We analyzed primary medical documentation, the surgical protocol, the results of blood examination, instrumental, cytological and pathohistological studies in a 34-year-old female. Results. The patient was diagnosed with PTC based on the results of preoperative fine-needle aspiration biopsy (FNAB) and underwent thyroidectomy, central and lateral neck dissection. Pathological examination confirmed multifocal PTC on the background of chronic thyroiditis, with metastases to the central lymph nodes. In the postoperative period, the patient underwent ablation with I131. Conclusions. Performing FNAB with subsequent cytological analysis in the preoperative period is critical in establishing the diagnosis of thyroid carcinoma and determining the extent of surgery. Effective surgical treatment followed by pathological examination is crucial for determining subsequent radioiodine therapy.