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<p>Intrathyroidal thymic carcinoma (ITTC) is an exceedingly rare thyroid malignancy, accounting for less than 0.15% of all thyroid cancers. We report two male patients aged 66 and 59&#xa0;years presenting with progressive neck masses, dysphagia, and tracheal compression. Both cases demonstrated extra-thyroidal extension with lymph node metastasis. Ultrasonography revealed a characteristic low-echoic mass with horizontal linear hyper-echogenicity at the lower thyroid pole. Definitive diagnosis was confirmed postoperatively through histopathology and immunohistochemistry (IHC), showing positivity for CD5, CD117, p63, and cytokeratin (CK), with negativity for thyroid transcription factor-1 (TTF-1). The first patient underwent total thyroidectomy with radical lymph node dissection followed by concurrent chemoradiotherapy (CCRT). The second patient, with unresectable tracheal invasion, received debulking surgery and adjuvant CCRT. Notably, this case also harbored concurrent papillary thyroid microcarcinoma, a finding documented in only eight previous reports. These cases highlight the diagnostic challenges of ITTC and highlight the importance of comprehensive histopathological evaluation and multidisciplinary management. Surgical resection remains the mainstay of therapy, with adjuvant CCRT recommended for advanced disease.</p>

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Intrathyroidal Thymic Carcinoma With Extra-Thyroid Invasion and Lymph Nodal Metastasis: Two Case Reports and Literature Review

  • 期刊论文

  • 发表日期：

    2026年5月14日

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  • Kuo-Yao Kao,
  • Chin-Hsuan Lin,
  • Shyh-Ching Chiou,
  • Sheng-Chun Chiu

摘要

Intrathyroidal thymic carcinoma (ITTC) is an exceedingly rare thyroid malignancy, accounting for less than 0.15% of all thyroid cancers. We report two male patients aged 66 and 59 years presenting with progressive neck masses, dysphagia, and tracheal compression. Both cases demonstrated extra-thyroidal extension with lymph node metastasis. Ultrasonography revealed a characteristic low-echoic mass with horizontal linear hyper-echogenicity at the lower thyroid pole. Definitive diagnosis was confirmed postoperatively through histopathology and immunohistochemistry (IHC), showing positivity for CD5, CD117, p63, and cytokeratin (CK), with negativity for thyroid transcription factor-1 (TTF-1). The first patient underwent total thyroidectomy with radical lymph node dissection followed by concurrent chemoradiotherapy (CCRT). The second patient, with unresectable tracheal invasion, received debulking surgery and adjuvant CCRT. Notably, this case also harbored concurrent papillary thyroid microcarcinoma, a finding documented in only eight previous reports. These cases highlight the diagnostic challenges of ITTC and highlight the importance of comprehensive histopathological evaluation and multidisciplinary management. Surgical resection remains the mainstay of therapy, with adjuvant CCRT recommended for advanced disease.