Brief Report

Atypical Presentations of Thyroid Cancer: Analysis of Forty-Eight Cases from A Tertiary Hospital in Cameroon

Bamidele Johnson Alegbeleye1, Hüseyin Keskin2
1Department of Surgery, St. Elizabeth Catholic General Hospital, Kumbo-Nso Bui Division, Cameroon
2Niğde Bor Devlet Hastanesi, Niğde, Turkey

Worldwide Medicine 2019; 1(3): 68-78 | DOI: 10.5455/ww.302644239      PDF


Abstract


Background: This is made possible because of the improved diagnostic modalities, such as ultrasonography, that has the capacity to detect very small lesions. Differentiated thyroid cancers with secondaries in sites other than the neck are relatively uncommon, and even rarer are the initial atypical presentation i.e. symptoms that are not related to the neck. The objective of this study was to bring to the fore the atypical cases of patients diagnosed with well-differentiated thyroid cancer and the complicating distant metastasis; with specific emphasis on presentation, management and outcome of patients with thyroid malignancy.
Methods: A retrospective cross-sectional descriptive study; in which we conducted a review of casefiles of 126 patients of who had thyroid surgeries. There were 48 cases of well-differentiated thyroid cancer with confirmed histopathological diagnosis on the final analysis and we subsequently identified and reviewed 5 patients who initially presented with unusual complaints to the thyroid clinic.
Results: During the study period under review, forty-eight consecutive patients, 4 male (8.4%) and 44 females (91.6%) with well-differentiated thyroid cancer, who had more than two follow-up visits to the Thyroid Clinic, over the last two years were included in this study. Subsequently, we described the profile of 5 selected patients with atypical presentations including four patients diagnosed with follicular carcinoma, and one patient with papillary carcinoma.
Conclusion: It is glaring from this case series that differentiated thyroid cancer can present with atypical manifestations. For the clinicians worldwide, a routine preoperative physical examination of the thyroid patient is mandatory. A high index of clinical suspicion, aggressive work-up and treatment are usually rewarding. We equally suggest and encourage a comprehensive multi-center study for a better understanding of the natural history of the thyroid cancer disease process.

Keywords: Thyroid cancer; Thyroid nodules; Distant metastases; Atypical presentations; Prognostic factors.