Case report: We report the case of a years-old female patient with personal history of cervical fistulizing tuberculous gumma diagnosed with right lateral cervical mass and Hashimoto nodular thyroiditis.
The patient underwent to surgical treatment which consisted in cervical cancer metastasis sites thyroidectomy and modified neck dissection with resection of internal right jugular vein adherent to the lymph node mass. Results: The final pathology report demonstrated a pT3mN0LV1Pn0 right lobe papillary thyroid carcinoma on Hashimoto thyroiditis while lymph papiloma hirsutoide presented giant epithelioid granulomas cervical cancer metastasis sites giant multinuclear Langhans cells and central necrosis consistent with the diagnosis of tuberculous adenitis.
The postoperative course was uneventful and the patient was referred to both TB and endocrinology specialist. Conclusions: Cervical tuberculous lymphadenitis can mimic metastatic adenopathy in papillary thyroid carcinoma and frequently the definitive diagnosis is achieved by excisional biopsy and histopathological examination.
Springer International, Management strategy of mycobacterial cervical lymphadenitis. J Laryngol Otol ; A review of 23 patients with tuberculosis of the head and neck.
Br J Oral Maxillofac Surg ; Case of papillary carcinoma of the thyroid gland with concurrent tuberculous lymphadenitis. Nihon Jibiinkoka Gakkai Kaiho ; A case of follicular carcinoma of thyroid gland with concurrent tuberculous lymphadenitises.
Facing such a scenario, the only solution is following a sequence of investigations and therapy steps towards a correct and complete diagnosis if possible.