DOI: 10.36347/sjmcr.2021.v09i02.001

Pages: 116-119

The columnar cell variant is a rare subtype of papillar thyroid carcinomas (PTC), characterized by its morphologic features and aggressive biologic course. Its diagnosis depends on the postoperative histological study of the surgical piece and its prognosis remains controversial. The treatment is mainly surgical while post-operative radio iodine therapy has proven its worth. We repot the case of a 73 years old patient, with history of arterial hypertension, having presented during a medical checkup a cervical painless swelling that was mobile on swallowing, and the lymph node areas were free. The thyroid laboratory tests were normal. The ultrasound cervical examination found a hetero multi nodular goiter classified TIRADS III. The patient has undergone a total thyroidectomy. The anatomopathological study of the surgical piece revealed a papillary carcinoma of the right lobe of the thyroid in its cylindrical cells variant measuring approximately 4 mm, located in contact with the thyroid capsule which it invades focally with presence of a single neoplastic embolus. Postoperative recovery was marked by transient hypocalcemia that was controlled by calcium supplementation and the patient was discharged from hospital 5 days later. The patient received 131-Iodine therapy (3.7 GBq) followed by post therapy whole body scans 6 days and 6 months later that didn’t show any pathological focus. The columnar cell variant of papillary thyroid carcinomas represents an aggressive variant of PTC potentially portending and unfavorable prognosis. The encapsulated form or small tumors demonstrates a more favorable outcome with indolent clinical process, which shows relatively slow growth and low incidence of recurrence or metastasis. The surgery still remains the main treatment while the post-operative radio iodine therapy plays an important role allowing the sterilization of tumor residues and thus reduces the rate of recurrence.