Primary Paraganglioma of the Thyroid Gland: Clinical and Immunohistological Analysis with a Literature Review

*Julien Feghaly,1 George Astras,2 Marios Loizou,3 Giannis Panayiotou,3 Ariana Mooradian1

1. St. George’s University of London (Cyprus), Nicosia, Cyprus
2. Oncology Department, American Medical Center, Nicosia, Cyprus
3. General Surgery Department, Nicosia General Hospital, Nicosia, Cyprus
*Correspondence to feghaly.julien@gmail.com

Disclosure: The authors have declared no conflicts of interest.
Received: 14.12.2015 Accepted: 23.02.2016
Citation: EMJ. 2016;1[2]:101-106.

Abstract

Primary paraganglioma of the thyroid is a rare neuroendocrine tumour, often mistaken for other thyroid neoplasms. Here, we describe a case of initially misdiagnosed primary paraganglioma of the thyroid and study its clinical presentation, management, investigation, and immunohistological findings.

A 72-year-old male presented with a left-sided solitary thyroid lobe and isthmus nodule. Ultrasound, fine needle aspiration, and computed tomography did not provide a clear diagnosis and subsequently, a left lobectomy and isthmusectomy were performed. The initial histopathological findings of the tumour revealed positivity to chromogranin and calcitonin, suggesting a medullary carcinoma replacing the left lobe of the thyroid. In a second histopathological review at an external laboratory, the tumour cells showed positive focal staining for chromogranin, but were negative for both calcitonin and monoclonal carcinoembryonic antigen, suggesting thyroid paraganglioma. This case highlights the importance of accurate histopathological diagnosis and the need to be aware of the possibility of thyroid paraganglioma initially presenting as a thyroid nodule.

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