Thyroblastoma in pregnancy: a case report and systematic review
Case Report

Thyroblastoma in pregnancy: a case report and systematic review

Xiang Yu Gao1 ORCID logo, Allison Young2, Jessica Hellyer3

1Washington State University Elson S. Floyd College of Medicine, Spokane, WA, USA; 2Incyte Diagnostics, Spokane, WA, USA; 3Cancer Care Northwest, Spokane, WA, USA

Contributions: (I) Conception and design: XY Gao, J Hellyer; (II) Administrative support: XY Gao, J Hellyer; (III) Provision of study materials or patients: A Young, J Hellyer; (IV) Collection and assembly of data: XY Gao, J Hellyer; (V) Data analysis and interpretation: XY Gao, J Hellyer; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors.

Correspondence to: Xiang Yu Gao, BS. Washington State University Elson S. Floyd College of Medicine, 412 E. Spokane Falls Blvd, Spokane, WA 99202, USA. Email: xiangyu.gao@wsu.edu.

Background: Thyroblastoma, formerly called malignant thyroid teratoma, is an exceedingly rare germ cell malignancy with a poor prognosis. Specific treatment guidelines are nonexistent due to the rarity of this disease. This case report highlights the outcomes and management of a malignant primary thyroid teratoma in a pregnant adult. There is limited information on the nonsurgical management of this disease with no systematic reviews on the outcomes of chemoradiation compared to chemotherapy alone or comparisons between different chemotherapy regimens. The primary objective of our systematic review is to compare the median overall survival (mOS) of patients treated with chemoradiation compared to chemotherapy alone. Secondary objective is to compare mOS of patients treated with cisplatin-based regimens to non-cisplatin regimens.

Case Description: A case of thyroblastoma in a 30-year-old patient at 11 weeks gestation is reported. The tumor was located in the thyroid with lymph node metastasis. Following R1 resection, adjuvant chemotherapy with bleomycin, etoposide, and cisplatin was administered until uncomplicated delivery at 36 weeks followed by chemoradiation with cisplatin. The patient is alive without evidence of disease 24 months from diagnosis. A systematic search of PubMed and Google Scholar for case series and reports of adults with thyroblastoma who underwent chemotherapy with reported follow-up times up to July 2024 was conducted. A total of 213 articles were found and assessed for eligibility by one reviewer. Of those, 18 articles reporting on 22 cases were included in our analysis. Twenty-two cases of patients with thyroblastomas were analyzed with a median age of 40 years and mOS of 44 months. Patients treated with chemoradiation had higher mOS than chemotherapy alone (53 vs. 24 months). Cases with cisplatin-based regimens had a higher mOS than non-cisplatin regimens (22 vs. 13 months).

Conclusions: Our case is an example of trimodality therapy leading to long-term survival in a patient with thyroblastoma. It also supports the use of platinum-based regimens. Additionally, bleomycin, etoposide, and cisplatin is well tolerated during pregnancy. Our systematic review supports the use of concurrent chemoradiation for curative treatment of locally advanced thyroblastoma and platinum-based regimens in thyroblastomas.

Keywords: Thyroid; teratoma; thyroblastoma; chemoradiation; case report

Received: 15 November 2024; Accepted: 17 April 2025; Published online: 26 June 2025.

doi: 10.21037/aot-24-51

Highlight box

Key findings

• This case is an example of trimodality therapy with a cisplatin-based regimen leading to a sustained disease-free survival in a patient with thyroblastoma. Moreover, the use of bleomycin, etoposide, and cisplatin during pregnancy was well tolerated and resulted in an uncomplicated full-term delivery, supporting its potential for use during pregnancy.

What is known and what is new?

• Thyroblastomas are insensitive to radiation and chemotherapy, leaving radical surgery as the standard of care. However, adjuvant chemotherapy has been shown to increase long-term survival outcomes, especially cisplatin-based therapy. Radiation therapy is controversial, but postoperative radiotherapy may benefit patients with malignant invasion of the esophagus, trachea, or larynx.

• Bleomycin, etoposide, and cisplatin have been reported to be well tolerated in cases with germ cell tumors.

• We present a patient with a locally advanced thyroblastoma during pregnancy who underwent adjuvant bleomycin, etoposide, and cisplatin followed by radiotherapy with cisplatin. Completion of therapy resulted in a complete response with no evidence of recurrence 24 months follow-up and uncomplicated delivery.

• A systematic review of similar cases showed that surgery with chemoradiation was associated with a higher median overall survival (OS) than surgery with chemotherapy alone.

What is the implication, and what should change now?

• Although surgical therapy is the mainstay of treatment, adjuvant modalities of chemotherapy and radiation have potential to improve OS, particularly in cases where complete resection is not achieved. Recognizing potential treatment options for this aggressive malignancy is a crucial step in improving survival outcomes for patients with thyroblastomas including in the setting of pregnancy.

Introduction

Background

Teratomas are tumors derived from more than one of the three embryonic germ layers. About 2–5% arise in extragonadal sites and only 6% of those occur in the head and neck, such as a primary thyroid teratoma (1,2). Formerly called malignant primary thyroid teratomas, thyroblastomas are recognized by their distinctive constellation of primitive multilineage elements and association with DICER1 hotspot mutations. They are exceedingly rare in adults with an aggressive clinical course and a poor prognosis (2,3). From the Surveillance, Epidemiology, and End Results (SEER) database, only 11 adult malignant teratoma cases occurred in the head and neck region from 1975 to 2016 in the U.S. population, with the most common location being the thyroid gland (4).

Rationale and knowledge gap

Secondary to its rarity, limited information exists on the treatment response of thyroblastomas. There are no formal guidelines for the management of this aggressive malignancy. In addition, the tolerance of chemotherapy during pregnancy is rarely reported in patients with teratomas, and even less so for thyroblastomas.

Objective

We report a case of a thyroblastoma in a 30-year-old pregnant woman who underwent chemotherapy during pregnancy. Her diagnosis, treatment plan, pregnancy, and disease-free survival reveal insights into the management of this malignancy. A systematic review of nonsurgical treatment options is also presented. The article is presented in accordance with the CARE and PRISMA reporting checklists (available at https://aot.amegroups.com/article/view/10.21037/aot-24-51/rc).

Case presentation

A 30-year-old previously healthy woman G2P1 who was 11 weeks pregnant presented with a rapidly enlarging neck mass. Her family history was remarkable for Hashimoto’s thyroiditis in her sister. Ultrasound revealed a 3.5 cm × 2.6 cm × 2.7 cm thyroid mass in the right lobe with a mildly heterogeneous and hypervascular thyroid parenchyma suspicious for thyroiditis. Fine needle aspiration (FNA) biopsy of the thyroid nodule was positive for a high-grade small round cell malignancy, not otherwise specified. An initial diagnosis of neuroendocrine neoplasm was made based on morphological findings and immunophenotype.

Computed tomography (CT) of the neck revealed a hypoattenuating ovoid 2.2 cm × 3.2 cm × 3.3 cm right thyroid mass (Figures 1,2). There is compression on the right aspect of the trachea causing approximately 50% narrowing as well as compression on the upper esophagus dorsally. Chest X-ray, magnetic resonance imaging (MRI) of brain, abdomen, and pelvis revealed no evidence of metastasis. Initial FNA biopsy revealed groups of neoplastic cells with neuroendocrine cytological features.

Figure 1 Axial soft tissue CT of neck with contrast 80 mL Isovue 370 IV. CT, computed tomography; IV, intravenous.
Figure 2 Sagittal soft tissue CT of the neck with contrast 80 mL Isovue 370 IV. CT, computed tomography; IV, intravenous.

Immunostaining at a tertiary medical center was diffusely positive for insulinoma-associated protein 1 (INSM1) and thyroid transcription factor-1 (TTF-1), focally positive for thyroglobulin. Immunostaining performed at the submitting hospital was positive for synaptophysin, very focally positive for chromogranin. The patient underwent a right thyroid lobectomy which revealed clear external compression of the trachea at approximately the 2 cm mark distal to the cords, however with no suggestion of frank invasion. R1 resection occurred without evidence of frank tracheal invasion. Central neck lymph node dissection obtained several nodes. This case was discussed at the multidisciplinary tumor board meeting and pathology was reviewed by an outside academic institution. The external pathology revealed a high-grade thyroblastoma with immature thyroid follicles, blastoma with neuroepithelial elements, and spindled mesenchymal proliferation within myxoid stroma (Figure 3). There are foci of necrosis and brisk mitotic activity. The mass was diagnosed as a malignant thyroblastoma, formerly malignant thyroid teratoma. Margins were positive with 1 lymph node involved.

Figure 3 Histopathology slides of thyroid tumor with immature thyroid follicles (A) and neuroepithelial and blastemal elements with myxoid stroma (B). Both images (H&E, ×400). H&E, hematoxylin and eosin.

There was no lymphovascular invasion identified in the primary tumor, but metastatic deposits were present in the lymph node tissue. Immunohistochemistry (IHC) at a tertiary medical center revealed AE1/3, CAM5.2, CK7, p40, S100 calcium-binding protein (S-100), SRY-box transcription factor 10 (SOX-10), TTF-1, paired box gene 8 (PAX-8), thyroglobulin, GATA binding protein 3 (GATA-3), synaptophysin, chromogranin, INSM1, cluster of differentiation 56 (CD56), Sal-like protein 4 (SALL4), cluster of differentiation 117 (CD117), desmin and myogenin are variably positive in the lesional cells. Switching/sucrose non-fermentable (SWI/SNF) related, matrix-associated actin-dependent regulator of chromatin subfamily A member 2/4 (SMARCA2/SMARCA4) and integrase interactor 1 (INI1) are retained. Cytokeratin (CK)20, CK5/6, GFAP, parathyroid hormone (PTH), caudal-type homeobox transcription factor 2 (CDX2) and cluster of differentiation 30 (CD30) are negative. The immunoprofile confirms the presence of thyroid follicular epithelial, neuroepithelial/blastemal, chondroid and rhabdomyoblastic differentiation.

Two months after diagnosis, ultrasound showed fetal growth appropriate for gestational age. Patient agreed to start treatment with 30 units of bleomycin, 100 mg/m2 etoposide, and 20 mg/m2 cisplatin (BEP) for 4 cycles q21 days. BEP was chosen due to good tolerance during pregnancy and was limited to 4 cycles to cease therapy past 32 weeks. MRI of the neck showed an ovoid lesion inferior to the right thyroid lobectomy bed measuring 12 mm × 9 mm and another ovoid nodule measuring 9 mm × 6 mm that is slightly more superior that may represent lymph nodes. After 3 cycles, MRI of the neck revealed a right paratracheal nodule caudal to thyroidectomy surgical bed that decreased in size to 9 mm × 10 mm × 6 mm from 22 mm × 10 mm × 9 mm. After 4 cycles, good fetal movement was present followed by a full-term uncomplicated delivery.

The patient tolerated BEP well with side effects limited to anemia, mild constipation, nausea, and initially low appetite. She also experienced dilutional anemia, mild fatigue, and hand swelling as a result of her pregnancy. MRI of the head and neck along with positron emission tomography (PET) scan obtained post-partum revealed no evidence of disease. She was subsequently started on 7 cycles of cisplatin 40 mg/m2 + radiation with 6,600 cGy 6x for 47 days, with the 7th cycle reduced to 30 mg/m2 due to supply shortage. The patient experienced severe dysphagia, odynophagia, tinnitus, and mild hearing loss from chemoradiation. She developed candidiasis and xerostomia during treatment and then developed radiation induced dysphagia as a late complication post-treatment and underwent esophageal dilation.

Regular abdominal, pelvic, thoracic, and neck imaging with CT and fluorodeoxyglucose (FDG)-PET were performed at 3-month intervals following the last cycle of treatment. Follow up, now 24 months out from completion of treatment, is without evidence of recurrence. Her child is healthy and has met the appropriate developmental milestones.

All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee(s) and with the Declaration of Helsinki and its subsequent amendments. Written informed consent was obtained from the patient for the publication of this case report and accompanying images. A copy of the written consent is available for review by the editorial office of this journal.

Discussion

Key findings

This case illustrates one approach to management of malignant thyroid teratoma during pregnancy. Using a combination of platinum-based therapy during pregnancy and chemoradiation for local control following delivery, the patient continues to be disease free at 24-month follow-up. The long-term survival with chemoradiation following surgical resection without clear margins is significant due to the resistance of this malignancy to nonsurgical interventions. The patient’s uncomplicated pregnancy while undergoing BEP therapy is an important aspect of this case.

Strengths and limitations

The trimodality approach of surgery and chemoradiation resulted in a complete response which supports the use of this approach. However, the combination itself complicates the ability to draw inferences on the potential association between surgery, chemotherapy, and radiation on the outcomes of thyroid teratomas. This case is unique in that the patient was pregnant during treatment and therefore treatment decisions were made which may not be applicable or generalizable to other patients.

Comparison with similar research

Nastos et al. published the first systematic review on thyroblastomas with a focus on surgical outcomes (2). However, there are no systematic reviews of nonsurgical modalities such as chemoradiation. To address this, a systematic review was conducted to compare the survival outcomes of chemotherapy with and without radiation in patients with thyroblastomas. A search for studies up to July 2024 was conducted through PubMed using the key words (primary thyroid teratoma) and (malignant thyroid teratoma) and (adult). A search through Google Scholar used the terms “thyroid teratoma” and “chemotherapy” for articles up to July 2024. Due to a very recent name change, “malignant thyroid teratoma” is still used in recently literature published. Inclusion criteria for abstract review were assessed independently by one reviewer, X.Y.G., and defined as follows: (I) malignant thyroid teratoma or thyroblastoma diagnosis; (II) 18 years and older; (III) reported use chemotherapy; (IV) case series or case reports; (V) reported follow-up times; and (VI) all articles in English.

For all eligible articles, the full-text was downloaded by X.Y.G. Data extraction was done by X.Y.G. and decisions on final inclusion were done by all authors. All included studies were case reports on rare conditions and therefore no further criteria for study quality assessment were applied and the risk for bias was not assessed. The systematic review was not preregistered and a protocol was not prepared. A Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) diagram of the process is illustrated (Figure 4).

Figure 4 PRISMA 2020 flow diagram. This diagram represents the process of study selection.

Twenty-two cases of thyroblastomas from 14 case reports and 4 case series were analyzed from the literature (Table 1). The mean age of all the cases is 40 years old with 27% male and 73% female. The median overall survival (mOS) of our population is 44 months.

Table 1

All published cases of thyroblastomas with reported follow-up times and chemotherapy or radiotherapy treatment course

Author/year Age (years)/sex Primary surgery; secondary Initial site; recurrence site Site of initial metastasis; recurrent metastasis 1st line chemotherapy Response 2nd line chemotherapy Radiotherapy Time until recurrence (months) Overall survival (months) Survival from Status
Nastos (2)/2021 65/F TT + central ND 5.5 cm in right thyroid; neck None Cisplatin NA None None 1 1 Surgery Alive as of writing
Miller (5)/2020 60/M Unspecified surgery 1.7 cm right thyroid; right iliac crest Level VI LN; appendicular skeleton Unspecified NA NA Sequential 6 12 Initial presentation Dead of disease
29/F Unspecified surgery 10 cm in right thyroid LN; para-aortic; clavicle Unspecified NA NA Concurrent 17; 34 52.8 Initial presentation Dead of disease
Pichler (6)/2014 43/M Left HT right subHT; left ND + sternotomy 5 cm × 3.5 cm in left thyroid; mass extending to mediastinum None; LNs left sternocleidomastoid muscle BEP NA PEI None 24 169 Surgery Alive without disease
Grewal (7)/2016 33/F TT + central ND + right lateral ND 6.5 cm × 4.5 cm × 4.5 cm in right thyroid; bilateral neck LN left supraclavicular, two LN right neck level 3; lungs Etoposide and cisplatin NA None None <4 36 Unspecified Alive without disease
Bidaye (8)/2021 29/M Left HT, paratracheal + level VI LN 4.4 cm × 3.5 cm × 2.4 cm and 1.3 cm × 1 cm × 1 cm in left thyroid Two level VI LNs, oesophageal wall BEP PR None Sequential NA 8 Radiotherapy completion Alive without disease
Kim (9)/2007 31/F TT + bilateral radical ND 7.5 cm × 5.0 cm × 4.7 cm in right thyroid 25 LNs in supraclavicular, mediastinal, and bilateral prevascular VAC alternate with IE NA None Sequential NA 22 Diagnosis Alive without disease
Kimler (10)/1978 37/F TT and left radical ND 4 cm × 3 cm × 2.5 cm in right thyroid. 16 cm × 12 cm × 7 cm extending to resection margins; left tonsillar area Metastases replacing the jugular LNs and associated soft tissue from mandible to clavicle; none VAC and dactinomycin PR None Sequential 2 6 Surgery Dead of disease
Ueno (3)/1998, Ting (11)/2019 36/F Right subHT; completion thyroidectomy and right functional ND 4.5 cm × 4 cm × 1.5 cm multinodular in thyroid; 4 cm × 4 cm right cervical mass None CISCA, POMB, ACE NA None NA 0.75 282 Chemotherapy completion Alive without disease
34/F TT Large right neck mass involving the esophagus and trachea Right lung CISCA, POMB, ACE CR None Sequential NA 275 Chemotherapy completion Alive without disease
Vilallonga (12)/2013 64/M TT; resection of 5-cm mass invading left paratracheal area and affecting the recurrent nerve Large in left thyroid; 2 cm between trachea and left neurovascular bundle. 3–4 cm thyroidectomy bed; same as metastasis None; none; expansive foraminal process with stenosis of C5 and C6 vertebrae and pulmonary metastasis Doxorubicin SD None Sequential 2; 1 14 Surgery Dead of disease
Chen (13)/1998 32/F HT Thyroid Three 1 cm × 1 cm LNs in right neck BEP CR None None NA 80 Surgery Alive without disease
Martins (14)/2006 37/F TT + LNs. 1 irresectable LN adherent to vessels 3.7 cm × 2.8 cm × 1.4 cm right thyroid LNs of neck and mediastinum BEP PR None Concurrent NA 12 Unspecified Alive without disease
Tsang (15)/2003 37/F subTT 4.3 cm × 3.0 cm × 4.4 cm mass in right thyroid Right cervical LN 1.8 cm BEP NA None Sequential NA 120 Diagnosis Alive without disease
Rabinowits (16)/2017 59/F TT and ND 3.7 cm × 3.6 cm × 6.7 cm isthmus and left thyroid. Left lateral 2.7 cm × 2.8 cm × 2.1 cm mass in levels II, III, and IV Multiple left jugular digastric LNs up to 1.6 cm VAC and IE† CR None None NA 53 Diagnosis Alive without disease
Rooper (17)/2020 65/F Unspecified surgery 1.9 cm thyroid Level VI LN Unspecified NA None None NA 125 Unspecified Alive without disease
29/F Unspecified surgery 10 cm thyroid Level VI LN; para-aortic then clavicle Unspecified NA None Sequential 17 53 Unspecified Dead of disease
42/F Unspecified surgery 8 cm thyroid None Unspecified NA None Sequential NA 64 Unspecified Alive without disease
Ting (11)/2019 25/F TT + bilateral central ND + left level 2–5 lateral ND + superior mediastinal dissection + upper partial sternotomy 7 cm left thyroid Left level IV and superioral mediastinal LNs BEP† PR None None NA 52 Chemotherapy completion Alive without disease
Buckley (18)/1986 27/M subTT 20 cm × 12 cm with compression of trachea Neck LNs and mediastinum; multiple pulmonary metastasis Cyclophosphamide, doxorubicin, VP-16, cisplatin, and steroids PD None Concurrent 1 1.5 Surgery Dead of disease
Ramadas (19)/1996 35/F TT 8 cm × 5 cm left thyroid; multiple in neck, largest 8 cm × 8 cm None; none; lung BEP CR None Sequential 1; 10.75 15 Surgery Dead of disease
Villacrés (20)/2018 38/M TT 9.5 cm × 7 cm × 6 cm in right thyroid None BEP NA None Sequential NA 12 Surgery Alive without disease

†, neoadjuvant use. ACE, actinomycin-D, cyclophosphamide, and etoposide; BEP, bleomycin, etoposide, and cisplatin; CISCA, cyclophosphamide, doxorubicin, and cisplatin; CR, complete response; F, female; HT, hemithyroidectomy; IE, ifosfamide and etoposide; LN, lymph node; M, male; NA, not available; ND, neck dissection; PD, progressive disease; PEI, cisplatin, etoposide, and ifosfamide; POMB, vincristine, methotrexate, bleomycin, and cisplatin; PR, partial response; SD, stable disease; subHT, partial hemithyroidectomy; subTT, subtotal thyroidectomy; TT, total thyroidectomy; VAC, vincristine, adriamycin (doxorubicin), cyclophosphamide.

All cases were treated with surgery. There was a total of 8 cases of locally advanced thyroblastomas that received chemotherapy. Of those, 4 received chemoradiation with an mOS of 53 months (5,15,17); this compares to a mOS of 24 months for chemotherapy alone (7,13,16,17). There is not enough data to analyze the difference between sequential versus concurrent chemotherapy and radiation in locally advanced disease.

There are no consensus guidelines on optimal chemotherapy regimen. In our review, the most common chemotherapy used was a cisplatin-based regimen consisting of bleomycin, etoposide, and cisplatin (n=8) (6,8,11,14-16,19,20). Other regimens included vincristine, doxorubicin, cyclophosphamide, ifosfamide, and methotrexate (9,10,12,16). The mOS of all analyzed cases (Table 1) with reported cisplatin-based regimens was 22 months (range of 1 to 282 months) (2,3,6-8,11,13-15,18-20). Four cases did not use a cisplatin-based regimen and had an mOS of 13 months (range 6 to 53 months) (9,10,12,16). The remaining cases has unspecified chemotherapy regimen and were not included in comparison (5,17).

Explanations of findings

Our patient with locally advanced thyroblastoma is alive without disease after chemotherapy followed by concurrent chemoradiation, supporting its use for treating thyroblastoma. This finding is supported by our systematic review, which showed that locally advanced cases with chemoradiation had a higher mOS than those who received with chemotherapy alone. Similarly, cisplatin-based regimens appear to have prolonged disease-free intervals, though the small sample size limits an ability to conduct a robust statistical comparison. This is consistent with other reports in the literature of cisplatin-based regimens being effective in treating malignant thyroid teratomas (2). In addition, BEP regimen is further supported as an option for use in pregnant patients due to good tolerance and uncomplicated delivery in our case.

Implications and actions needed

The results of our systematic review and case report both support the use of concurrent chemoradiation for curative treatment of locally advanced thyroblastoma and platinum-based regimens in thyroblastomas. The uncomplicated delivery in our case report supports the use of BEP during pregnancy. Due to the small population size in our study and lack of statistical power for analysis, these findings prompt the need for further studies to be conducted with larger populations for more definitive conclusions.

Conclusions

Surgery with chemoradiation use is likely beneficial for increasing mOS in locally advanced thyroblastoma. Platinum-based regimens may also improve mOS. BEP is recommended for use in pregnant patients. Results are limited by a lack of statistical power.

Acknowledgments

The authors would like to thank Incyte Diagnostics in Spokane, WA for assistance with obtaining histopathology images.

Footnote

Reporting Checklist: The authors have completed the CARE and PRISMA reporting checklists. Available at https://aot.amegroups.com/article/view/10.21037/aot-24-51/rc

Peer Review File: Available at https://aot.amegroups.com/article/view/10.21037/aot-24-51/prf

Funding: None.

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://aot.amegroups.com/article/view/10.21037/aot-24-51/coif). J.H. is a Medical Director for Clinical Trials with Tempus and reports one honorarium at a Binaytara Foundation conference. The other authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee(s) and with the Declaration of Helsinki and its subsequent amendments. Written informed consent was obtained from the patient for the publication of this case report and accompanying images. A copy of the written consent is available for review by the editorial office of this journal.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

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doi: 10.21037/aot-24-51
Cite this article as: Gao XY, Young A, Hellyer J. Thyroblastoma in pregnancy: a case report and systematic review. Ann Thyroid 2025;10:2.

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