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15TH INTERNATIONAL GASTROINTESTINAL CANCERS CONFERENCE, Antalya, Turkey, 4 - 07 December 2025, pp.32-33, (Full Text)
SYNCHRONOUS PAPILLARY THYROID CARCINOMA AND HEPATOCELLULAR CARCINOMA IN A NON-CIRRHOTIC, NON-VIRAL LIVER: A RARE INCIDENTAL ASSOCIATION Mustafa Ersoy Kütahya Sağlık Bilimleri Üniversitesi Tıp Fakültesi, İç Hastalıkları Ana Bilim Dalı, Kütahya Case Description: A 42-year-old woman with no history of viral hepatitis or cirrhosis was incidentally found to have a hepatic mass during routine imaging. MRI revealed a 5.2 cm hypervascular lesion in the right hepatic lobe with periportal lymphadenopathy. Liver enzymes and tumor markers were within normal limits, and viral serology (HBsAg, anti-HCV) was negative. The patient underwent right hepatectomy with perihepatic lymph node dissection. Histopathologic examination confirmed hepatocellular carcinoma (HCC) arising in a non-cirrhotic, non-viral liver with metastasis limited to regional lymph nodes. Surgical margins were negative, and complete resection was achieved. For staging and systemic evaluation, FDG-PET/CT demonstrated FDG-avid upper mediastinal and cervical lymphadenopathies. EBUS-guided biopsy revealed metastatic papillary thyroid carcinoma (PTC). Neck ultrasonography showed a 1.5 cm TI-RADS 5 nodule in the right thyroid lobe. The patient subsequently underwent total thyroidectomy and mediastinal lymph node dissection, which confirmed classic variant papillary thyroid carcinoma with nodal metastases. Postoperative recovery was uneventful. The patient later received radioactive iodine ablation (RAI, 100 mCi I-131) for differentiated thyroid carcinoma. Follow-up imaging demonstrated no evidence of residual or recurrent disease in either the thyroid bed or the liver. Laboratory tests, including liver function and thyroid hormone levels, remained stable under levothyroxine suppression therapy. Discussion: The coexistence of papillary thyroid carcinoma and hepatocellular carcinoma is exceedingly rare, especially in non-cirrhotic and non-viral livers. To our knowledge, only isolated cases have been reported. The synchronous presentation in this patient likely represents two independent primary malig-nancies rather than metastatic spread. While both tumors were incidentally detected and surgically treated at potentially curative stages, their coexistence highlights the importance of thorough systemic evaluation when unexpected lesions or lymphadenopathies are identified. This case underscores that HCC can arise in non-cirrhotic livers and that multidisciplinary management ensures favorable outcomes in rare synchronous malignancies. Conclusion: We report a rare case of synchronous papillary thyroid carcinoma and hepatocellular carcinoma in a non-cirrhotic, non-viral liver. Complete surgical resection and subsequent RAI therapy achieved disease-free status. Careful pathological evaluation and comprehensive systemic assessment are essential for optimal management of such exceptional presentations. Keywords: Hepatocellular carcinoma, Papillary thyroid carcinoma, Synchronous double primary