Papillary thyroid carcinoma (PTC) primarily located in the pyramidal lobe of the thyroid gland is extremely rare, therefore the clinical and pathological features are not well understood. The authors describe a case of PTC of the pyramidal lobe, in a 77‐year‐old woman who underwent en bloc total thyroidectomy with pyramidal lobe, hyoid bone and cervical lymph node excision. In line with the present case, current literature reports a greater presence of worse prognostic factors, namely extrathyroidal extension, advanced T stage or presence of cervical lymph node metastasis. Recently, a new classification has been suggested—Upper Neck Papillary Thyroid Cancer (UPTC)—which encompasses these carcinomas, Delphi ganglion metastases and thyroglossal duct cyst carcinomas, with potential clinical and therapeutic implications, particularly the need for orthotopic thyroidectomy. Also, the complete excision of the pyramidal lobe during thyroidectomy may influence the success of radioactive iodine therapy and the patient's follow‐up surveillance.

Background Papillary thyroid carcinoma (PTC) primarily located in the pyramidal lobe of the thyroid gland is extremely rare, so the clinical and pathological features are not well understood. Case The authors describe a case of multifocal PTC with larger pyramidal lobe tumour, in a 77-year-old female patient who underwent en bloc total thyroidectomy with pyramidal lobe, hyoid bone and cervical lymph node excision. Conclusion In line with the present case, current literature reports a greater presence of worse prognostic factors, namely extrathyroidal extension, advanced T stage or presence of cervical lymph node metastasis. Recently, a new classification has been suggested – Upper Neck Papillary Thyroid Cancer (UPTC) – which encompasses these carcinomas, Delphi ganglion metastases and thyroglossal duct cyst carcinomas, with potential clinical and therapeutic implications, particularly the need for orthotopic thyroidectomy. Also, the complete excision of the pyramidal lobe during thyroidectomy may influence the success of radioactive iodine therapy and the patient’s follow-up surveillance.

Papillary thyroid carcinoma of the pyramidal lobe is rare. We describe a case of a 77-year-old woman who corroborates current literature findings, namely greater presence of adverse prognostic factors. Upper Neck Papillary Thyroid Cancer is a new entity, proposed to group these tumors with potential clinical and therapeutic implications.

A 41-year-old female patient was referred to the head and neck surgery department because of a large midline submandibular mass that was diagnostic for functioning thyroid tissue in a totally ectopic location.

Background:Sarcopenia as well as abnormalities in body composition are common features in several chronic diseases and have been shown to lead to increased morbidity and mortality. However, their assessment in young patients with axial spondyloarthritis (axSpA) has not been performed thus far.Objectives:To assess the skeletal muscle mass, strength and performance as well as body composition in patients with axSpA compared to healthy controls.Methods:Patients between 18 and 50 years of age with the diagnosis of axSpA and short disease duration (under 10 years) and classified according to the ASAS criteria were included. Healthy individuals matched by gender and age (1:1) were used as control group. Muscle strength (MS) was assessed by resisted flexion of the dominant forearm using a hand dynamometer. Muscle performance was assessed with the 60 second sit-to-stand test (STS60) and with 5 times sit-to-stand test (STS5). Body composition was assessed with octapolar multifrequency bioelectrical impedance analysis (InBody 770). The level of physical activity was measured by the IPAQ questionnaire. BASDAI and BASFI were used to evaluated disease activity and function, respectively. All measures (except age and disease duration) are reported as median and 25th and 75th percentiles. Non-parametric tests were used to compare groups.Results:A total of 27 patients and 27 controls were included [mean age (36.5 ± SD 1.0), 66% males]. AxSpA patients had symptom duration of 7.0 ± SD 0.9 years, BASDAI 2.7 (1.4-3.6) and BASFI 0.9 (0.3-3.2). Compared to controls, axSpA patients had less MS in the dominant upper limb (DUL) (46.0 (37.5-70.6) vs 71.2 (54.1-83.4) kg, p=0.006) and worse performance on the STS60 test (48.0 (27.5-64.3) vs 63.0 (53.0-68.0) repetitions, p=0.010). These differences were maintained after normalization for lean mass (LM) (MS_DUL/LM_DUL and STS60/Total_LM). In addition, compared to controls, axSpA patients had higher body fat (BF) (19.8 (12.1-29.1) vs 15.7 (10.1-22.2) kg, p=0.041), torso fat (TF) (10.3 (6.3-15.9) vs 8.1 (5.1-11.1) kg, p=0.450) and visceral fat (VF) (87.3 (52.7-145.1) vs 65.4 (41.8-96.4) cm2, p=0.034). No differences were registered for weight, body mass index, total body water, extracellular water, fat free mass, LM and bone mineral content between groups. The level of physical activity, measured by the IPAQ questionnaire, was identical between patients and healthy controls (p=0.500).Conclusion:Compared to healthy controls, young axSpA patients have a reduction in muscle strength and muscle performance with maintenance of muscle mass and levels of physical activity. These preliminary results underline the relevance of further investigations.Abstract THU0403 – Table 1 Subject characteristicsVariablePatientsN=27ControlsN=27p-valueAge (years)37 (32-43) 36(30-44)0.808Gender (♂% : ♀%)66.7:33.366.7:33.30.922§Symptom duration (years)7.0 (4.0-10.0)------------IPAQ(low% : moderate-high%)29.2:70.820.8:79.20.505§LM (Kg)50.1 (44.5-57.8)54.1 (43.2-60.2)0.592BF (Kg)19.8 (12.1-29.1)15.7 (10.1-22.2)0.041TF (Kg)...