papillary thyroid carcinoma with nodular fasciitis-like stroma in a 28-year-old patient

Papillary thyroid carcinoma (ptc) is considered as a relatively common type of malignancy showing a wide morphologic spectrum. different variants of this tumor have been reported. among ptc variants, ptc with nodular fasciitis-like stroma (ptc‑fls) is rare. this variant consists of stromal components rich in spindle cells and accounts for 60-80% of tumors. in addition, there are small foci of epithelial components in ptc‑fls though its features are similar to conventional ptc. in this case study, we present a new case with ptc‑fls. the case is a 28-year-old female who was referred to the ent clinic due to a painless mass on the anterior part of her neck. the mass showed a gradual increase in size over the 6 months prior to her referral. thyroid test results were normal. ultrasound imaging demonstrated an 84 × 36 mm heterogeneous nodule in the right thyroid lobe without calcifications but increased vascularity. there were also some reactive lymph nodes in both submandibular areas. an ultrasound-guided fine-needle aspiration (fna) biopsy of the right thyroid lobe nodule revealed a benign thyroid adenomatoid nodule. following right thyroid lobectomy, final pathologic studies confirmed a diagnosis of ptc with exuberant fibromatosis-like stroma. in the 20-day post-surgery visit, the patient was found asymptomatic. re-evaluation of the left thyroid lobe and followup were recommended. in this study, a diagnosis of a rare variant of ptc, i.e., ptcfls, was made through a combination of ultrasonography, fine needle aspiration cytology, and histological examination.