Head & Neck Case Review 2020-04

Head & Neck Case Review

April, 2020

History

A 19-year-old female presented with a rapidly enlarging 7.5 cm left-sided thyroid mass. Multiple, bilateral pulmonary nodules measuring up to 2 cm were present on CT scan, consistent with metastatic disease. She underwent total thyroidectomy and left neck dissection followed by radioactive iodine ablation. Images from the thyroid resection are shown below.

Images

Necrosis
Mitoses
TTF-1
Thyroglobulin
Calcitonin

Quiz

Q1. Which gene is most likely to harbor a mutation in this patient’s tumor?

  • A. BRAF
  • B. DICER1
  • C. RAS
  • D. TERT

Q2. The prognosis for this tumor type is better in young people than in older adults.

  • A. True
  • B. False

Diagnosis

Contributor

Rebecca Chernock, M.D.
Associate Professor
Department of Pathology and Immunology
Washington University in St. Louis

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