Radical surgery for primary thyroid lymphoma in a Filipino female: Report of a case and review of literature

INTRODUCTION: Primary thyroid lymphomas are rare. They constitute only 2% of all thyroid malignancies. It is important to distinguish it from other tumors of the thyroid due to the marked difference in approach to management. Preoperative diagnostic confirmation is ideal to allow for appropriate therapeutic management, which consists of chemotherapy with or without radiotherapy and to avoid unnecessary surgery. In a select group of patients, surgery may be of benefit to relieve obstructive symptoms and establish diagnosis. CASE PRESENTATION: Presented herein is a 48 year old female with a progressively enlarging neck mass previously being treated for Hashimoto’s thyroiditis. Obstructive symptoms and a preoperative diagnosis of anaplastic carcinoma prompted surgical intervention. The patient underwent resection of the tumor with a total thyroidectomy and bilateral neck dissection. Post -operative diagnosis of non Hodgkins diffuse large B cell type of lymphoma was made. DISCUSSION: Primary thyroid lymphomas are rare tumors that may present similarly with some types of thyroid malignancies. An accurate diagnosis is important because non-surgical treatment options like combination chemotherapy and radiotherapy may be effective while sparing the patient from unnecessary radical surgery. CONCLUSION: Primary thyroid lymphoma must be a differential diagnosis in patients presenting with large thyroid tumors in the background of Hashimoto’s thyroiditis. Although chemoradiotherapy is the preferred treatment approach, there is a role for surgery in cases of tumor obstruction and uncertain diagnosis.