Background. Inflammatory myofibroblastic tumors are extremely rare neoplasms of unknown etiology and can occur at any anatomic location but most commonly are found in lungs and gastrointestinal tract. Inflammatory myofibroblastic tumors of thyroid are usually benign with no incidence of recurrence, however extrathyroidal neoplasms may exhibit malignant transformation with fatal outcome.
Clinical findings. We present a rare clinical case of a 50 - year old lithuanian female with thyroid inflammatory myofibroblastic tumor with clinical manifestation of breathlessness, dry cough, hemoptysis, neck mass, arrhythmia and loss of consciousness. Because of elevated D dimers values, pulmonary artery thromboembolism was suspected and CT scan was performed. CT showed no pulmonary embolism, but revealed a large tumor in the neck. After patient was investigated in cardiology department to exclude sick sinus syndrome, fine needle aspiration cytology of thyroid nodus was done with non-diagnostic results. Thyroid scintigraphy showed cold node suggesting malignancy.
Results. The patient underwent toi tal thyroidectomy. Histopathology analysis revealed two separative tumors: follicular carcinoma and thyroid inflammatory myofibroblastic tumor. Because of follicular carcinoma the patient was treated with radioiodine. She was comfortable after treatment with thyroid hormone replacement therapy and had no evidence of disease recurrence after 6 month follow-up.
Conclusions. We managed to find only 20 cases of this type of tumor located in thyroid reported in the literature. And we did not find reports with two concomitant thyroid tumors including inflammatory myofibroblastic tumor.
