Thyroid hemiagenesis with hurthle cell carcinoma- a rare case

Author: 
Rajkamal Kanojiya, Himal Rathod, Rajat Goyal, Shubham Singh, Ashna Jaggi, Nalini Joshi, Rekha Chaudhary and Rishi Deep Jain

Introduction: Thyroid hemiagenesis (TH) is a congenital anomaly which is rare in which one lobe fails to develop, it is more seen on the left lobe of thyroid. The exact process for thyroid morphogenesis remain unclear. We present a case of right lobe TH associated with Hurthle cell carcinoma.
Case presentation: A 35 years old woman was admitted with a neck lump increasing in size since 1 years. There were no features of hyperthyroidism and hypothyroidism. There was a palpable, painless 2 cm mass in the middle of the neck. Initial ultrasonography (USG) showed an enlarged left lobe, with hypoechoic lesion with cystic component and calcification in it .(TIRADS 4). Fine needle aspiration cytology was suggestive of malignancy. Pathology result was Hurthle cell carcinoma. Patient was planned for a thyroidectomy surgery. Intraoperatively, the right thyroid with isthmus was absent.
Discussion: Thyroid hemiagenesis can be seen by using USG due to its practicality and cost effectiveness reasons. Follow up included of systematic monitoring of thyroid morphology and hormonal functions should follow the diagnosis of TH. Neck exploration surgery may be needed to be performed to clarify any discrepancy and confirm the diagnosis.
Conclusion: Thorough history taking and physical examination might not help to reach the diagnosis of TH accompanying thyroid diseases. However, discrepancy may occur. Hence, surgery may be needed to be performed to clarify the discrepancy and confirm the diagnosis.

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DOI: 
http://dx.doi.org/10.24327/ijcar.2022.643.0144
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