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BACKGROUND: Oncocytic thyroid carcinoma (OTC), previously known as Hürthle cell carcinoma, is a distinct subtype of differentiated thyroid cancer accounting for approximately 5% of all thyroid malignancies. Synchronous thyroid tumors are extremely rare, accounting < 1% of all thyroid tumors. CASE SUMMARY: We report a 38-year-old female with synchronous OTC in the left lobe and papillary thyroid carcinoma (PTC) in the right lobe, who had a history of thyroid nodules for 8 years. Ultrasound showed that the OTC was a large, hypoechoic, solid nodule with regular margins and internal vascularity. Contrast-enhanced computed tomography confirmed a heterogeneous, well-circumscribed enhancing mass extruding the thyroid boundary, with no cervical lymph node enlargement in the left lateral compartment. The right-lobe PTC was an ill-circumscribed node with spot calcification and internal nonuniform enhancement. It was smaller than the left-lobe OTC, and enlarged lymph nodes in the right lateral cervical compartment were identified. The patient underwent total thyroidectomy. Histopathology confirmed the diagnosis of synchronous minimally invasive left-lobe OTC right-lobe PTC, with right lateral neck compartment lymph node metastasis. CONCLUSION: This case highlights the importance of recognizing imaging features of coexisting PTC and OTC for preoperative evaluation and surgical management.
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Gong et al. (2026) studied this question.
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