A Case of Thyroid Carcinoma Combined With Thyroid Hemiagenesis

Introduction and Importance: Thyroid hemiagenesis (THA) is a rare congenital anomaly characterized by the underdevelopment or complete absence of one thyroid lobe. The coexistence of thyroid carcinoma in patients with this condition is exceedingly uncommon, with only a limited number of cases reported worldwide. Awareness of this presentation is essential due to its diagnostic and therapeutic implications. Case Presentation: We report a 36-year-old female who presented with a right thyroid nodule and was subsequently diagnosed with papillary thyroid carcinoma in the context of left THA. Ultrasonography and contrast-enhanced computed tomography (CT) confirmed the absence of the left thyroid lobe and isthmus. Fine-needle aspiration biopsy (FNAB) was not performed due to the small size of the nodule and patient preference. The patient underwent right thyroidectomy with prophylactic right central neck dissection. Intraoperative frozen section confirmed papillary carcinoma, guiding the surgical extent. Postoperative pathology revealed a 0.4 cm papillary carcinoma without lymph node metastasis. Clinical Discussion: THA is typically asymptomatic and often discovered incidentally. However, anatomical variations may complicate the diagnosis and surgical management of thyroid carcinoma. Preservation of parathyroid glands, recurrent laryngeal nerves, and awareness of possible ectopic thyroid tissue, are critical during surgery. Conclusion: Papillary thyroid carcinoma occurring in THA is rare but clinically significant. This case highlights the importance of careful preoperative assessment and the value of intraoperative frozen section analysis in determining the need for central neck dissection. Early detection, individualized surgical planning, and multidisciplinary follow-up can optimize outcomes in such atypical presentations.