Primary Thyroid Lymphoma: Two different presentations of a rare disease

Primary thyroid lymphoma is a rare disorder accounting for about 2% of all malignant lymphomas and less than 5% of thyroid malignancies. It is an aggressive disease with poor outcome. The majority of thyroid lymphomas are non-Hodgkin lymphomas of B-cell origin. Majority of cases occur in women in the sixth decade. We report two cases of pri­mary thyroid lymphoma and highlight the clinical issues and challenges posed by this rare disease. Both cases presented with respiratory obstructive symptoms that required surgical intervention. The optimal management for a primary thyroid lym­phoma be it chemotherapy, radiotherapy, surgery or monoclonal antibodies is still de­batable. The role for surgery has evolved through the years but its importance in emergency situations should not be overlooked. Both our patients had to undergo sur­gery but only one patient received additional chemotherapy and radiotherapy. These two case reports illustrated the difficulties in managing this rare disorder.