Thyroid cancer in Gardner’s syndrome: Case report and review of literature
A 40-year-old gentleman with no previous medical or family history was referred to our hospital with a diagnosis of adenocarcinoma of the rectum. At our institute, a colonoscopic evaluation revealed multiple polyps scattered throughout the colon. He underwent panproctocolectomy with ileostomy. The histology showed tubulovillous and adenomatous polys in caecum, colon and rectum with a moderately differentiated adenocarcinoma of rectum. All lymph nodes were negative []. Fifteen months later, he had a swelling around the stoma site. CT scan showed a 9.5x5.6x7.5 cm peritoneal mass at the site of ileostomy with multiple smaller similar lesions throughout the abdomen. The tumor was excised (R1 resection) with reconstruction of the abdominal wall, histologically showing it to be a desmoid tumor The patient was given weekly systemic therapy with vinblastine, methotrexate and tamoxifen (methotrexate 30 mg/m2 weekly intravenously, vinblastine 6 mg/m2 weekly intravenously and tamoxifen 20 mg/m2 twice a day orally daily) for 6 cycles. Six months later (21 months following the diagnosis of colon carcinoma), CT scan showed a partial response of the desmoid tumors. A new thyroid nodule was detected at a screening ultrasound of the neck. FNAC confirmed the diagnosis to be papillary carcinoma of thyroid []. Total thyroidectomy was done which revealed a well-differentiated papillary carcinoma of the thyroid. The patient is currently on maintenance doses of thyroxine and is continued on tamoxifen. . Almost 3 years since the initial detection of Gardner’s syndrome, the patient continues to remain stable.