Indian Journal of Surgical Oncology

, Volume 9, Issue 4, pp 592–594 | Cite as

HATRICK—Synchronous Triple Primary Tumors of Thyroid

  • A. P. Roshini
  • Rakesh RameshEmail author
  • T. Rajalakshmi
Case Report


Multiple primary cancer (MPC) has an incidence of 1.8% and is defined as having two or more cancers in a single patient. Synchronous tumors are defined as ≥ 2 primary tumors occurring within 6 months of diagnosis of the first primary tumor. We present a case of a 27-year-old female patient who presented with a painless, gradually progressive right-sided neck swelling for the last 1 year with no systemic complaints. Examination revealed a 4 × 3-cm, firm, smooth surfaced swelling on right lobe of thyroid. USG neck showed a hypoechoic solid nodule on the right lobe and the left lobe was normal. FNAC showed features of adenomatous colloid nodule, Bethesda II. Right hemithyroidectomy specimen revealed evidence of triple tumors—not otherwise-specified (NOS) tumor, papillary carcinoma thyroid, and medullary carcinoma thyroid, which was confirmed with positivity on IHC with synaptophysin, CEA, and chromogranin. Concurrent appearance of NOS, PTC, and medullary carcinoma thyroid in the very same patient is extremely rare and has not been previously reported in the English literature.


Triple thyroid tumor Not otherwise specified (NOS) Papillary thyroid carcinoma (PTC) Medullary carcinoma thyroid 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.


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Copyright information

© Indian Association of Surgical Oncology 2018

Authors and Affiliations

  1. 1.St. John’s Medical College and HospitalBengaluruIndia
  2. 2.Department of Surgical OncologySt. John’s Medical College and HospitalBengaluruIndia
  3. 3.Department of PathologySt. John’s Medical College and HospitalBengaluruIndia

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