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Case Report: Giant Thyroid Angiolipoma—Challenging Clinical Diagnosis and Novel Genetic Alterations

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Abstract

Background

A 64-year-old man presented with a 7.8 cm lipomatous thyroid mass discovered on magnetic resonance imaging.

Methods

After two non-diagnostic fine needle aspirations (FNAs) were performed, computed tomography (CT) revealed features concerning for malignancy including central necrosis and infiltrative borders. A third FNA was still non-diagnostic. Total thyroidectomy was performed.

Results

Upon pathologic examination, the final diagnosis was primary thyroid angiolipoma. The lesion contained central fat necrosis with ischemic features, attributable to the FNAs.

Conclusion

Ours is the third published case report of this rare entity. To date, no lipomatous thyroid tumor has undergone extensive genomic testing. Next-generation sequencing of our case revealed multiple genetic alterations, supporting the concept of angiolipomas being true neoplasms. Whereas the two previously reported cases in the literature were radiographically much smaller and appeared indolent, the large tumor in our case exhibited radiographic features concerning for liposarcoma, which belied the benign final pathologic diagnosis. Our case demonstrates that conservative surgical management (partial thyroidectomy) may be considered for lipomatous thyroid tumors, with further interventions to be determined only after final pathologic diagnosis.

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Data Availability

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Acknowledgements

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Funding

There is no funding to report for this study.

Author information

Authors and Affiliations

  1. Department of Pathology, New York University (NYU) Langone Health, New York, NY, USA

    Reid Wilkins, George Jour, Cheng Z. Liu & Fang Zhou

  2. Department of Radiology, NYU Langone Health, New York, NY, USA

    Elcin Zan

  3. Department of Medicine, NYU Langone Health, New York, NY, USA

    Olga Leonardi

  4. Department of Surgery, NYU Langone Health, New York, NY, USA

    Kepal N. Patel

  5. Department of Otolaryngology-Head and Neck Surgery, NYU Langone Health, New York, NY, USA

    Kepal N. Patel & Adam S. Jacobson

Authors
  1. Reid Wilkins
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  2. Elcin Zan
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  6. George Jour
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  7. Cheng Z. Liu
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  8. Fang Zhou
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Correspondence to Fang Zhou.

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The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Written informed consent was obtained from the patient for publication of this case report and accompanying images. Institutional board approval is not required at our institution for de-identified retrospective case reports.

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Wilkins, R., Zan, E., Leonardi, O. et al. Case Report: Giant Thyroid Angiolipoma—Challenging Clinical Diagnosis and Novel Genetic Alterations. Head and Neck Pathol 17, 246–252 (2023). https://doi.org/10.1007/s12105-022-01500-2

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  • DOI: https://doi.org/10.1007/s12105-022-01500-2

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