2025 Poster Presentations
P087: A CASE OF PAPILLARY THYROID CARCINOMA WITH ANAPLASTIC DEDIFFERENTIATION AND SKULL BASE METASTASIS
Desiree T Campbell, BS1; Daniel P Russo, MD2; Tarunya Vedere, MD3; Esma Ersoy, MD4; Gary Gong, MD, PhD5; Todd Falcone, MD2; Danielle E Scarola, MD2; 1University of Connecticut School of Medicine; 2Division of Otolaryngology, Department of Surgery, University of Connecticut Health Center; 3Division of Endocrinology, Department of Medicine, University of Connecticut Health Center; 4Department of Pathology, University of Connecticut Health Center; 5Department of Radiology, University of Connecticut Health Center
Papillary Thyroid Carcinoma (PTC) represents the most prevalent subtype of thyroid malignancy worldwide. While PTC is associated with an excellent prognosis and favorable response to standard therapies, some subtypes of PTC, especially those with dedifferentiation to anaplastic thyroid carcinoma (ATC), carry worse prognosis and a more aggressive clinical course. In this case report we report a patient with an initial presentation of cranial nerve IX, XII, and recurrent laryngeal nerve palsy. Imaging demonstrated an isolated thyroid nodule (Figure 1) on CT neck. Fine needle aspirate showed papillary thyroid carcinoma. Further imaging work up with MRI brain demonstrated a lesion of the hypoglossal canal with stenosis of the canal (Figure 2) as well as PET avidity at the skull base, concerning for metastatic disease (Figure 3). Eventual thyroidectomy returned positive for papillary thyroid carcinoma with anaplastic thyroid carcinoma de-differentiation (Figure 4). Thus, this case demonstrates a rare presentation of papillary thyroid cancer with rapid de-differentiation and an initial presentation of cranial neuropathy. Through this report, we highlight the importance of age in the evolution of PTC into ATC, the potential for thyroid carcinoma to present with cranial neuropathy, and the need to tailor treatment approaches to the patient’s overall health status and specific tumor pathological characteristics.
