Mixed Medullary Papillary Thyroid Carcinoma in Hyperfunctioning Hot Nodule: A Case Report and Review of the Literature
Bibliographic record
Abstract
Mixed medullary papillary carcinoma (MMPC) is a rare variant of papillary thyroid carcinoma, according to the WHO classification and it presents as a single lesion histologically composed of two distinct and intermingled neoplastic cell patterns. The histogenesis is still debatable. The lymph node metastases are usually present at the time of the diagnosis and distal metastases may appear late during follow-up. At least 13 similar lesions have been reported in the literature. We describe the case of a 61-year-old woman with a mixed medullary papillary carcinoma found in a hyperfunctioning thyroid nodule and negative pre-surgical serum calcitonin. After surgery, the patient started suppressive L-thyroxine therapy and underwent radioiodine ablation. The follow-up for both papillary and medullary components has shown no signs of persistence or recurrence of disease five years after surgery. However, the rarity of the MMPCs makes the management and the prognosis of these tumors still unclear.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.005 | 0.005 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".