BREAKING NEWS! French Physicians Uncover Malignant Pseudothyroiditis, a New Type of Thyroid Cancer In A Post-COVID Individual!
Malignant Pseudothyroiditis, A Type of Thyroid Anaplastic Carcinoma Can Be Misdiagnosed As Subacute Thyroiditis Which Is Prevalent In Many Post COVID Individuals!
: In a recent discovery, French physicians have identified a rare and deadly form of thyroid cancer known as Malignant Pseudothyroiditis (MPT) in a patient who had previously recovered from COVID-19. This finding is significant as MPT can present with symptoms similar to those of Subacute Thyroiditis (SAT), leading to misdiagnosis and delayed treatment.
Corresponding author, Dr Edouard Ghanassia from the Diagnosis and interventional thyroidology center in France told Thailand Medical
News, “Already, the prevalence of Subacute Thyroiditis (SAT) is very high among many post COVID individuals and there is a very high possibility that doctors are missing out on more cases of Malignant Pseudothyroiditis, a type of Thyroid Anaplastic Carcinoma due to misdiagnosis!”
The case highlights the need for heightened awareness among healthcare professionals regarding the potential emergence of atypical clinical presentations in individuals who have had COVID-19.
Anaplastic Thyroid Carcinoma (ATC), the cancerous form of MPT, is a rare type of cancer with a poor prognosis. It is often diagnosed late due to its resemblance to SAT, which is characterized by an enlarged goiter and inflammatory symptoms. MPT often progresses into an aggressive cancer in a very short span.
With the COVID-19 pandemic, physicians have observed a rise in cases of SAT in individuals who have contracted the virus, and the symptoms of SAT have been enriched by the presence of COVID-19 symptoms, leading to the emergence of atypical clinical pictures.
The reported case involves a 60-year-old patient who developed symptoms of SAT one month after recovering from COVID-19. The patient presented with fever, palpitations, weight loss, and a painful goiter. Initial blood tests indicated an inflammatory response and elevated thyroid hormone levels, suggestive of SAT triggered by the COVID-19 infection. However, ultrasound imaging revealed atypical features, including a heterogeneous echostructure with irregular margins, raising concerns about a more sinister underlying condition.
Further investigations, including core-needle biopsies and a CT scan, were performed to establish a definitive diagnosis. Unfortunately, the histological analysis presented challenges, and the diagnosis of MPT was not confirmed until a bundle of clinical, radiological, and histological evidence was considered. Despite receiving palliative chemotherapy, the patient's condition rapidly deteriorated, and he passed away.
This case is the first reported instance of MPT mimicking SAT in a post-COVID individual. It underlines the importance of considering the possibility of MPT in patients with atypical clinical presentations, especially those who have recently recovered from COVID-19.
The study also reviewed thirty-five previously published cases of MPT and discussed the mechanisms underlying its development, as well as the ultrasound
and histological features associated with the condition.
The similarities between MPT and SAT, both in terms of clinical presentation and imaging characteristics, make accurate diagnosis challenging. The authors stress the importance of performing neck ultrasounds in individuals with painful goiters and considering a US-guided core-needle biopsy in cases of atypia. They also emphasize the need to promptly refer patients to expert centers for specialized care.
The case raises several intriguing questions, such as the potential role of COVID-19 infection in influencing the clinical presentation of MPT and the relationship between viral infections and thyroid carcinogenesis. Further research is needed to explore these aspects and to improve the understanding and management of MPT.
In conclusion, the discovery of MPT in a post-COVID patient highlights the importance of vigilance among healthcare professionals in identifying atypical clinical presentations. The study serves as a reminder that COVID-19 can impact the clinical manifestation of various diseases. It also underscores the significance of accurate and timely diagnosis to improve patient outcomes in cases of rare and aggressive cancers like MPT.
The study findings were published on a preprint server and are currently being peer reviewed.
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