1996 Volume 35 Issue 2 Pages 161-167
We report herein a multicentric papillary thyroid carcinoma in an 18-year old Japanese woman with familial adenomatous polyposis (FAP).
The aspirated material from the right thyroid nodule showed cohesive cell clusters consisiting of admixtures of solid and papillary cell arrangements. In the former, tumor cells possessed abundant cytoplasms, coarse nuclear chromatin, and a small number of nuclear grooves. Abundant light-green positive amorphous substances were observed in the cell clusters. In the latter, the tumor cells showed irregular nuclear contours and had numerous intra-nuclear inclusions. We ultimately confirmed a cytological diagnosis of thyroid papillary carcinoma. The patient underwent left thyroidectomy. Histological examination of the surgical specimen showed multicentric papillary carcinoma. Twelve days later, barium-enema examination and colonoscopy revealed many colonic polyps. She then underwent total recto-colectomy and ileo-proctostomy. Pathologic examination showed adenomatous polyposis complicated by focal adenocarcinomas. About one year later, she was found to have a nodule in the remaining thyroid. Fine needle aspiration cytology showed thyroid papillary carcinoma. She underwent additional right thyroidectomy.
The course of this case suggests that all patients with a familial history of FAP should have regular thyroid examinations, both before and after the diagnosis of FAP. In addition, discovery of thyroid carcinoma in young patients should prompt a precautionary search for occult FAP.
