Publication:

Hobnail variety of papillary cell carcinoma thyroid mimicking a thyroglossal cyst: a rare presentation

The hobnail variant of papillary thyroid carcinoma (HVPTC) is a newly described aggressive variant relative to that of the classical PTC. There have been genetic markers like the BRAF V600E mutation associated with more aggressiveness and a higher rate of recurrence and mortality. Here we discuss a case of thyroid swelling which clinically resembled a thyroglossal cyst due to movement of the swelling with tongue protrusion. Imaging indicated a multilobulated cystic swelling arising from the thyroid gland. FNAC was suggestive of colloid goitre. Total thyroidectomy was done and histopathology revealed HVPTC.HVPTC is an aggresive variant and if diagnosed preoperatively may warrant more extensive surgery. One must also have a high index of suspicion for thyroid swellings that are large with variable clinical presentations (including mutiple septations) as they may appear benign on FNAC but may prove to be malignant on histopathology.