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Background <p>Macrofollicular variant of papillary thyroid carcinoma (MFV-PTC) is an exceptionally rare subtype that mimics benign colloid nodules. Due to its insidious microscopic appearance, it poses a significant risk of cytological misdiagnosis.</p> Case presentation <p>A 38-year-old woman presented with a suspicious solid thyroid nodule. Two consecutive fine-needle aspiration (FNA) biopsies were reported as Bethesda Category II (Benign). A third FNA finally suggested malignancy, and subsequent histopathology confirmed MFV-PTC. Following total thyroidectomy and radioactive iodine ablation, the patient remains disease-free at 12-month follow-up.</p> Conclusions <p>MFV-PTC is a rare but critical differential diagnosis in follicular lesions. This case highlights the potential for false-negative cytology and the importance of clinical correlation in managing macrofollicular thyroid nodules.</p>

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A rare challenging macrofollicular thyroid carcinoma: a case report

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月21日

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  • Eren Altun,
  • Ismail Safa Poyrazoglu,
  • Ahmet Barcın,
  • Emin Topcu

摘要

Background

Macrofollicular variant of papillary thyroid carcinoma (MFV-PTC) is an exceptionally rare subtype that mimics benign colloid nodules. Due to its insidious microscopic appearance, it poses a significant risk of cytological misdiagnosis.

Case presentation

A 38-year-old woman presented with a suspicious solid thyroid nodule. Two consecutive fine-needle aspiration (FNA) biopsies were reported as Bethesda Category II (Benign). A third FNA finally suggested malignancy, and subsequent histopathology confirmed MFV-PTC. Following total thyroidectomy and radioactive iodine ablation, the patient remains disease-free at 12-month follow-up.

Conclusions

MFV-PTC is a rare but critical differential diagnosis in follicular lesions. This case highlights the potential for false-negative cytology and the importance of clinical correlation in managing macrofollicular thyroid nodules.