Fast Track Management of Primary Thyroid Lymphoma in the Very Elderly Patient - Applications Médicales et Industrielles (LPC Caen)
Article Dans Une Revue Current Oncology Année : 2023

Fast Track Management of Primary Thyroid Lymphoma in the Very Elderly Patient

Pierre Yves Marcy
  • Fonction : Auteur
Frederic Bauduer
  • Fonction : Auteur
Juliette Thariat
  • Fonction : Auteur
Laboratoire de physique corpusculaire de Caen
Olivier Gisserot
  • Fonction : Auteur
Edouard Ghanassia
  • Fonction : Auteur
Bruno Chetaille
  • Fonction : Auteur
Laurys Boudin
  • Fonction : Auteur
Jean Baptiste Morvan
  • Fonction : Auteur

Résumé

A rapid growing cervical mass mobile while swallowing is the most common clinical presentation of severe thyroid malignancy. A 91-year-old female patient with a history of Hashimoto thyroiditis presented with clinical compressive neck symptoms. The patient had gastric Maltoma diagnosed that was surgically resected thirty years ago. A straightforward process was needed to reach full histological diagnosis and initiate prompt therapy. Ultrasound (US) showed a 67 mm hypoechoic left thyroid mass with reticulated pattern without signs of locoregional invasion. Percutaneous trans isthmic US-guided 18G core needle biopsy (CNB) disclosed diffuse large B cell lymphoma of the thyroid gland. FDG PET revealed two distinct thyroid and gastric foci (both SUVmax 39.1). Therapy was initiated rapidly to decrease clinical symptoms in this aggressive stage III primitive malignant thyroid lymphoma. The prognostic nomogram was calculated by using a seven-item scale, which disclosed a one-year overall survival rate of 52%. The patient underwent three R-CVP chemotherapy courses, then refused further treatment and died within five months. Real-time US-guided CNB approach led to rapid patient’s management that was tailored to patient’s characteristics. Transformation of Maltoma into diffuse large B cell lymphoma (DLBCL) into two body areas is deemed to be extremely rare.

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Physique [physics]
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Soumis le : jeudi 30 mai 2024-12:21:31

Dernière modification le : mercredi 21 août 2024-03:03:56

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hal-04150612 , version 1 (30-05-2024)

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Pierre Yves Marcy, Frederic Bauduer, Juliette Thariat, Olivier Gisserot, Edouard Ghanassia, et al.. Fast Track Management of Primary Thyroid Lymphoma in the Very Elderly Patient. Current Oncology, 2023, 30 (6), pp.5816-5827. ⟨10.3390/curroncol30060435⟩. ⟨hal-04150612⟩

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