Carcinoma papilífero da tireoide, uma abordagem diagnóstica não usual: relato de caso

Abstract

Objective: report of Papillary Thyroid Carcinoma with suspected diagnosis from un unusual approach with Thyroglobulin measurement in material obtained by cervical lymph node puncture. Methods: data obtained by reviewing medical records. Results: a 32-year-old woman Underwent Cervical Ultrasound (USC), which revealed a 15 mm nodule in the lower third of the right thyroid lobe. He also had elevated serum TSH levels and anti-thyroglobulin antibodies. Levothyroxine replacement was started and a nodule biopsy was performed, which was negative for neoplastic cells (class II- Bethesda). After a year, a new USC revealed a thyroid nodule with similar dimensions and characteristics and a lymph node with a hypergenic component at level IV on the right. Lymph node puncture resulted in negative oncotic cytology. Thyroglobulin dosage was requested is a wash of material from the puncture of this lymph node, showing high levels. With the suspicion of differentiated thyroid carcinoma, thyroidectomy was performed. The anatomopathological analysis confirmed the diagnosis of Papillary Thyroid Carcinoma of the classic variant and perithyroid lymph nodes with metastasis. Conclusion: Thyroglobulin measurement in suspected cervical lymph node puncture material, despite the absence of neoplastic cells, was crucial for the oncological diagnosis.