Case Report
 
Role of immunohistochemistry in metastatic clear cell variant of follicular thyroid carcinoma: A case report
Yash Pradeep Vaidya1, Rajan Vaithianathan2, Ramanathan Manickam3, Dhananjay Kotasthane4
1MBBS, Postgraduate, General Surgery, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University, Pondicherry, India.
2MS (Gen. Surgery), FRCS, Associate Professor, General Surgery, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University, Pondicherry, India.
3MS (Gen. Surgery), Professor and Head, General Surgery, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University, Pondicherry, India.
4MD (Pathology), Professor and Head, Pathology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University, Pondicherry, India.

Article ID: Z01201703CR10773YV
doi:10.5348/ijcri-201734-CR-10773

Address correspondence to:
Yash Pradeep Vaidya
Department of General Surgery, Mahatma Gandhi Medical College and Research Institute
Sri Balaji Vidyapeeth University
Pondicherry
India, 607402

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How to cite this article
Vaidya YP, Vaithianathan R, Manickam R, Kotasthane D. Role of immunohistochemistry in metastatic clear cell variant of follicular thyroid carcinoma: A case report. Int J Case Rep Images 2017;8(3):196–200.


Abstract
Introduction: Clear cell variant of follicular thyroid carcinoma with synchronous bony metastasis and a normal thyroid stimulating hormone level, is an extremely rare condition.
Case Report: A 55-year-old male was presented to us with a painful swelling in the right arm. The biopsy showed clear cell adenocarcinoma, raising concerns for a metastatic renal cell carcinoma. Computed tomography scan of abdomen failed to show any renal lesions. A detailed physical examination revealed a small nodule of the right thyroid lobe. Fine needle aspiration cytology (FNAC) of the nodule was reported as follicular neoplasm. A right hemithyroidectomy and the subsequent completion thyroidectomy showed clear cell type of follicular thyroid carcinoma. Immunohistochemistry for thyroglobulin (Tg) further confirmed the diagnosis.
Conclusion: Clear cell variant of follicular thyroid carcinoma is a very rare condition, hence a high index of suspicion is essential for diagnosis. The importance of performing a detailed physical examination cannot be more emphasized as small thyroid lesion like in this case can be easily missed, leading to a delay in diagnosis.

Keywords: Clear cell variant, Follicular thyroid carcinoma, Thyroglobulin, Thyroidectomy


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Author Contributions
Yash Pradeep Vaidya – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Rajan Vaithianathan – Substantial contributions to conception and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Ramanathan Manickam – Substantial contributions to conception and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Dhananjay Kotasthane – Substantial contributions to conception and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
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The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2017 Yash Pradeep Vaidya et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



About The Authors

Yash Vaidya is Final Year Resident at Department of General Surgery, Mahatma Gandhi Medical College and Research Institute, Pondicherry, India. He has published multiple research papers in national and international academic journals. He intends to pursue career in cardiothoracic and vascular surgery in future.



Rajan Vaithianathan is Associate Professor at Department of General Surgery, Mahatma Gandhi Medical College and Research Institute, Pondicherry, India. He has published several research papers in national and international academic journals. His field of interest is surgical gastroenterology.



Ramanathan Manickam is Professor and Head at Department of General Surgery, Mahatma Gandhi Medical College and Research Institute, Pondicherry, India. He has published several research papers in national and international academic journals. His field of interest is surgical gastroenterology.



Dhananjay Kotasthane is Professor and Head at Department of Pathology, Mahatma Gandhi Medical College and Research Institute, Pondicherry, India.