Simultaneous quadruple pathology in the thyroid gland: A case report with literature review

It is unusual for 2 distinct thyroid tumors to coexist, and even rarer to observe more than 2 thyroid pathologies alongside a malignant lymph node process. This report describes a highly rare presentation of multiple thyroid diseases coexisting with an extra-thyroidal malignancy. A 32-year-old female presented with suspicious thyroid nodules and bilateral pathological lymphadenopathy on ultrasound.

Fine-needle aspiration (FNA) suggested both papillary thyroid carcinoma (PTC) and Hodgkin lymphoma (HL). Histopathology confirmed multifocal papillary thyroid microcarcinomas (PTMC), hyalinizing trabecular tumor (HTT), Hashimoto’s thyroiditis (HT), and HL in a cervical lymph node. Managing such cases is clinically challenging due to their rarity and variable presentations.

Further research is needed to guide evaluation and treatment strategies.