Bilateral papillary thyroid cancer with normal aberrant thyroid tissue
A 43-year-old man presented in 2021, with bilateral thyroid nodules detected by ultra-sonography 5 months earlier. He had no night sweats, no respiratory or dysphagia difficulty, nor other pressure symptoms. An ultrasound scan interpreted nodules in left and right thyroid gland, which were irregular defined, low-echo with calcification. In addition, there was a mass measured about 28 × 5 × 20 mm in front of internal jugular vein. Fine needle aspiration biopsy was advised and histological investigation showed bilateral papillary thyroid cancer. Therefore, total thyroidectomy was recommended.\nThe patient was hospitalized in 22 March 2021. The level of thyroglobulin was as high as 230.80 ng/ml, whereas all other thyroid functional indicators were normal. Chest and abdominal examination as well as preoperative fiberoptic laryngoscopy were all normal. He underwent contrast-enhanced cervical computed tomography (CT) scan, which confirmed bilateral possible malignant nodularity in thyroid gland and an ~1.6 × 0.6-cm hyperdensity deep to the right sternocleidomastoid muscle (SCM, ). Total thyroidectomy and bilateral central neck dissection was operated. A metastatic lymph node encapsulated the left recurrent laryngeal nerve. In the same time, the mass lateral to the right SCM was removed, which was separated from the thyroid gland (). Intraoperative neuromonitoring information was normal. Pathology demonstrated bilateral papillary thyroid cancer (the size of cancer in left lobe was 2.2 cm, right 1.6 cm) with three lymph node metastases. However, the aberrant thyroid was histological free of cancer. Postoperative radioactive iodine therapy (RAI) was recommended for this patient.