Thyroid tuberculosis with Papillary Thyroid Carcinoma in a 19 year-old Female

Objectives To present the co – existence of Papillary Thyroid Carcinoma with Primary Thyroid Tuberculosis To discuss the prevalence of Papillary Thyroid Carcinoma and Primary Thyroid Tuberculosis with its clinical presentation and treatment To explore the probable relationship of Carcinoma and Tuberculosis Methods Design: Case Report Setting: Tertiary Government Hospital Patient: One Results Patient is a nineteen-year old Filipino female with history of a left thyroid nodule for 4 years. Systemic examination was unremarkable. Patient was clinically euthyroid. Fine needle aspiration biopsy of the thyroid nodule showed atypical cells suspicious of papillary thyroid carcinoma. Left thyroid lobectomy with rapid frozen section was performed. Confirming a diagnosis of papillary thyroid carcinoma. Hence, completion thyroidectomy was done. Final histopathology report revealed Papillary thyroid carcinoma of the left lobe, microcarcinoma of the isthmus and incidental note of tuberculosis of the Right lobe. Post operative management included commencement of anti-TB medications for nine months prior to contemplation of anti-TB medications for nine months prior to contemplation of administration of RAI therapy. Conclusion Tuberculosis of the thyroid gland is an uncommon entity and is usually asymptomatic. The presence of tuberculosis in the thyroid gland of a patient also diagnosed with papillary thyroid carcinoma is an even more rare condition. The co-existence of these two disease also create a management dilemma in terms of which among the post-operative treatment should be prioritized – RAI therapy which can eliminate malignant remnants but can cause immunosuppression, or anti-TB medications which can eliminate the infection but can delay complete cancer treatment. Thyroid tuberculosis may be associated with the development of carcinoma due to its tumorogenic effects. Further studies are still needed to establish this association.