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A 64-year-old patient consulted following the discovery of a right retro-thyroid lesion during a Doppler examination of the neck vessels.

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Ultrasound shows a lesion in contact with the lower pole of the right thyroid lobe measuring  31 x 15 mm of hypoechoic solid echostructure with regular clear contours.

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The Doppler shows weak vascularization.

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Diagnostic hypothesis:

  1. Giant parathyroid adenoma?

  2. Bulky thyroid nodule in extra-thyroid position?

  3. Bulky adenopathy?

  4. Others………

 

A requested PTH assay shows normal parathyroid balance with normal PTH and no hypercalcemia.

 

The thyroid biological assessment is also normal.

 

A cytopuncture carried out for cytological analysis and dosage of thyroglobulin and PTH.

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The in situ assay shows the absence of thyroglobuline  and PTH.

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Cytopuncture is non-contributory.

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In the absence of diagnosis, a surgical decision accepted by the patient.

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Examination of the surgical specimen compatible with un  altered schwannoma.

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Absence of signs of malignancy.

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