Warthin – like papillary carcinoma of the thyroid gland: case report and literature review

We present a case of Warthin-like papillary thyroid carcinoma in a 22-year-old woman and a review of the literature on the topic.
The patient had the occasional discovery of a hypoechoic thyroid nodule of approximately 18 mm, characterized by irregular
margins, hyperechoic spots, rich intra- and perilesional vascularization, and a suspicious enlarged right laterocervical lymph
node. Fine-needle aspiration was performed for both lesions and the diagnosis of papillary thyroid carcinoma without lymph
node involvement was made. The patient underwent thyroidectomy and central neck lymphadenectomy without complications.
Histopathological examination suggested a Warthin-like papillary carcinoma of the thyroid gland, with all the removed lymph
nodes being free of disease. The patient subsequently underwent iodine ablative therapy and she remains free of disease one
year after surgery. Warthin-like papillary thyroid carcinoma is a recently described variant of papillary thyroid cancer that is
frequently associated with lymphocytic thyroiditis. Morphologically, it resembles Warthin tumors of the salivary glands, with T
and B lymphocytes infiltrating the stalks of papillae lined with oncocytic cells. Surgical and postoperative management is identical
to that of classic differentiated thyroid cancer, while prognosis seems to be favourable.