Case report

Simultaneous medullary and papillary thyroid cancer: two case reports

Gianlorenzo Dionigi¹ , Patrizia Castano¹ , Valentina Bertolini² , Luigi Boni¹ , Francesca Rovera¹ , Maria Laura Tanda³ , Carlo Capella² , Luigi Bartalena³ and Renzo Dionigi¹

¹  Department of Surgical Sciences, University of Insubria, Varese, Italy

²  Department of Human Morphology, University of Insubria, Varese, Italy

³  Department of Clinical Medicine, Division of Endocrinology, University of Insubria, Varese, Italy

author email corresponding author email

Journal of Medical Case Reports 2007, 1:133doi:10.1186/1752-1947-1-133

Published:	12 November 2007

Abstract

Background

Papillary thyroid carcinoma (PTC) and medullary thyroid carcinoma (MTC) have always been considered different from each other; in their incidence, their cell origin and their histopathological features.

Case presentation

This paper describes two rare cases of the simultaneous occurrence of MTC and PTC in the thyroid gland. Case 1 is unique for different reasons: (a) the patient was affected by both multicentric MTC and PTC; (b) a "composite thyroid carcinoma" with mixed feautures of MTC and PTC carcinomas was found in the istmus of the gland; and (c) these tumors were associated with diffuse lymphocytic-type thyroiditis (LT). Case 2 is notable for the long follow up: 16 years disease free.

Conclusion

There are only 16 reports in the English medical literature describing a total of 20 cases of concurrent occurrence of both PTC and MTC in the same thyroid gland. We discuss whether the finding of another cancer in these patients was coincidental or from possible activation of a common tumorigenic pathway for both follicular and parafollicular thyroid cells.