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篇名 Toxoplasmosis lymphadenitis of parotid gland concurrent with papillary thyroid carcinoma: A dilemma in differential diagnosis
作者 Yu‑Chen Hsu, Chien‑Chin Chen, Chih‑Hsuan Changchien
卷期/出版年月 50卷6期 (2017/12)
頁次 215-219
摘要 We report a case of toxoplasmosis lymphadenitis simulating a parotid mass concurrent with a papillary thyroid carcinoma. A 55‑year‑old male presented symptomless masses in the left lower neck and right preauricular region for 2 months. Physical examination revealed a 2 cm × 2‑cm firm mass in the right parotid region and a 3‑cm diameter soft mass in the left lobe of thyroid gland. Computed tomography confirmed a lobulated nodule, embedded in the right parotid gland, and; a left thyroid nodule, which resembled a papillary thyroid carcinoma. Fine‑needle aspiration (FNA) of the left thyroid lobe suggested a papillary thyroid carcinoma. A radical thyroidectomy, central neck lymph node dissection, and right superficial parotidectomy were performed. Histopathological examination of the surgical specimen supported the diagnosis of a papillary carcinoma of the left thyroid lobe and toxoplasmosis lymphadenitis in the right parotid gland. Specific serum immunoglobulin tests suggested a current infection with Toxoplasma gondii. The patient was administered pyrimethamine and sulfadiazine for 4 weeks and underwent I-131 ablation for the functional thyroid remnants in the anterior neck. At a 16‑month follow‑up, the patient was clinically fit and recurrence free. This case highlights the importance of remaining clinically vigilant to differentiate an unusual metastatic carcinoma from inflammation of the parotid gland. A consideration of toxoplasmosis lymphadenitis by thorough history taking, appropriate serologic tests, and selective use of FNA may provide combined preoperative information for differential diagnosis of a parotid mass and help avoid an unnecessary surgical procedure.
關鍵詞 Lymph node, parotid gland, thyroid carcinoma, toxoplasmosis
分類 Case report

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