Familial Non Medullary Thyroid Cancer: Clinic Cases and Review of literature

A woman of 28, with absence of comorbidity, family history negative for thyroid disease, was in treatment at our out-patients surgery for Hashimoto’s thyroiditis with levothyroxine. The sonographic followup in May 2011 revealed the presence of a suspicious lump. The patient underwent FNAB (type 5) with bilateral cervical-lymphadenopathy suspicious for disease. The patient underwent total thyroidectomy en bloc. Histological examination of frozen sections diagnosed papillary carcinoma. As per protocol was performed dissection of the sixth cervical level and laterocervical lymphadenectomy bilaterally. The definitive histological examination showed metastases in five of the ten nodes of the sixth level (pT1N1Mx) and latero-cervical lymph nodes free of disease. Later the patient was subjected to radioiodine therapy, and now she is free from disease. Her sister underwent echo-thyroid screening that showed multinodular goiter, with a suspicious lump of 2 cm in diameter, with a vascular pattern type IV and grade III FNA, located on the middle third of the right lobe, cervical-lymphadenopathy was absent, metastasis was suspected, and therefore was subjected to surgical treatment. During surgery, the piece was sent for histological examination of frozen sections of the suspected lump that diagnosed the presence of papillary thyroid carcinoma (pT1N0Mx) and for this reason we proceeded to the dissection of level VI laterocervical. Screening was extended to other family members and three thirddegree relatives were diagnosed with multinodular goiter. They met both major criteria and one minor was diagnosed with FNMTC. Abstract