Case Report: Multifocal non-invasive follicular thyroid neoplasm with papillary-like nuclear features presenting in a female child

Abstract

Non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) was introduced as a separate entity by the World Health Organization in 2017 with strict inclusion and exclusion criteria. Most NIFTP cases have been reported in adults and few cases have been diagnosed in children. Here, we present a classic case of NIFTP affecting a 10-year old female child. We also review previous reports of NIFTP in children regarding size, focality, nodal metastasis, recurrence, type of operation and follow-up data. The present report adds a new case of NIFTP in the paediatric age group characterized by multifocality, absence of nodal invasion and indolent course until last follow-up, recommending less aggressive management.

First bilateral non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) co-occurring with bilateral papillary thyroid microcarcinoma. Case report and literature review

“…As regards to thyroid involvement, Table 1 depicts some variation in terms of the extent of the involvement of the thyroid. While one case had multinodular enlargement of the gland [ 10 ], others [ 11 , 12 ] presented with enlargement of only one half of the gland. Given such an extent of variation, there seems to be no fixed set of physical examination findings or presentation that can provide an indication to the surgical team as to nature of the lesions.…”

“…In terms of investigations, thyroid function tests (TFTs) are required to determine the activity of the thyroid gland. Table 1 shows that in all the cases reviewed, the patients were euthyroid indicating that the nodules were not active [ [10] , [11] , [12] , 16 ]. We are in agreement, our patient was euthyroid, although the patient had delivered around one month before the first set of TFTs which could cause unexpected endocrine fluctuations.…”