1
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Zhang X, Wei B, Nong L, Zhang H, Zhang J, Ye J. To diagnose primary and secondary squamous cell carcinoma of the thyroid with ultrasound malignancy risk stratification. Front Endocrinol (Lausanne) 2024; 14:1238775. [PMID: 38495474 PMCID: PMC10940438 DOI: 10.3389/fendo.2023.1238775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 10/17/2023] [Indexed: 03/19/2024] Open
Abstract
Objectives This study aimed to investigate the clinico-ultrasound features of primary squamous cell carcinoma of the thyroid (PSCCT) and secondary SCCT (SSCCT) and evaluate the accuracy of fine needle aspiration (FNA) recommendation for SCCT with American College of Radiology-Thyroid Imaging and Reporting Data System (ACR-TIRADS) and Chinese-TIRADS (C-TIRADS). Materials and methods We retrieved 26 SCCT patients (11 PSCCT, 15 SSCCT) from our hospital's pathology database (5,718 patients with thyroid malignancy) over 23 years. Medical records and ultrasound data of the 26 patients with 27 SCCTs were analyzed retrospectively, and each SCCT focus was categorized based on the two TIRADSs. Results For 26 patients (21 males, 5 females) with an age range of 42-81 years, rapidly enlarging thyroid/neck nodules (18/26, 69.2%), dysphagia (7/26, 26.9%), hoarseness (6/26, 23.1%), dyspnea (5/26, 19.6%), cough (4/26, 15.4%), neck pain (2/26, 7.7%), B symptoms (2/26, 7.7%), and blood in sputum (1/26, 3.8%) were presented at diagnosis. Five asymptomatic patients (5/26, 19.2%) were detected by ultrasound. Hoarseness was more common in PSCCT (5/11, 45.5%) than in SSCCT (1/15, 6.7%) (P=0.032). For 27 SCCTs with a mean size of 3.7 ± 1.3 cm, the ultrasound features consisted of solid (25/27, 92.6%) or almost completely solid composition (2/27, 7.4%), hypoechoic (17/27, 63%) and very hypoechoic echogenicity (10/27, 37%), irregular/lobulated margin with extra-thyroidal extension (27/27, 100%), taller-than-wide shape (13/27, 48.1%), punctate echogenic foci (6/27, 22.2%), hypervascularity (23/27, 85.2%) and involved neck lymph (13/26, 50.0%). A total of 27 SCCTs were evaluated as high malignancy risk stratification (≥TR4 and 4B) by the two TIRADSs and recommended FNA in 96.3-100% (26/27, 27/27). Pathologically, more than half of PSCCTs (7/12, 58.3%) and a quarter of SSCCTs (4/15, 26.7%) were poorly differentiated, while moderately and well-differentiated grades were observed in 5 PSCCTs and 11 SSCCTs (P=0.007). Thirteen patients (50.0%) underwent surgery with radical operation in 5 cases (5/13, 38.5%). Conclusion SCCT is an extremely rare and aggressive malignancy with a male predominance. PSCCT and SSCCT had similar clinical and ultrasound features except for tumor differentiation and the symptom of hoarseness. SCCT showed a high malignancy risk stratification in ACR-TIRADS and C-TIRADS, with a high rate of FNA recommendation.
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Affiliation(s)
- Xiumei Zhang
- Department of Ultrasound, Peking University First Hospital, Beijing, China
| | - Boxiong Wei
- Department of Ultrasound, Peking University First Hospital, Beijing, China
| | - Lin Nong
- Department of Pathology, Peking University First Hospital, Beijing, China
| | - Hong Zhang
- Department of Pathology, Peking University First Hospital, Beijing, China
| | - Jixin Zhang
- Department of Pathology, Peking University First Hospital, Beijing, China
| | - Jingming Ye
- Department of General Surgery, Peking University First Hospital, Beijing, China
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2
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Gupta RK, John A, Ravina M, Arora RD. A unique case of anaplastic thyroid carcinoma comprising of two distinct patterns osteoclastic variant and squamous cell carcinoma in separate lobe imitating collision tumor: A case report. Diagn Cytopathol 2023; 51:E89-E93. [PMID: 36458378 DOI: 10.1002/dc.25085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/15/2022] [Accepted: 11/21/2022] [Indexed: 12/04/2022]
Abstract
Anaplastic thyroid carcinoma with two distinct morphologies in two lobes with no intermixing is very rare and not reported earlier. Furthermore, osteoclastic variant of anaplastic thyroid carcinoma as well as primary squamous cell carcinoma without any differentiated components are also very rare with only few reported cases describing their cytological features. Herein, we are reporting a unique and first case of anaplastic thyroid carcinoma comprising of two distinct patterns osteoclastic variant and squamous cell carcinoma in different lobes in a 55-years-old lady with review of literature.
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Affiliation(s)
- Rakesh Kumar Gupta
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Raipur, India
| | - Aishwarya John
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Raipur, India
| | - Mudalsha Ravina
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Raipur, India
| | - Ripu Daman Arora
- Department of Otolaryngology and Head & Neck Surgery, All India Institute of Medical Sciences, Raipur, India
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3
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Bojoga A, Stănescu L, Badiu C. Collision tumors of the thyroid. A special clinical and pathological entity. Arch Clin Cases 2022; 8:84-90. [PMID: 34984231 PMCID: PMC8717004 DOI: 10.22551/2021.33.0804.10191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Thyroid collision tumors are rare entities that designate two histologically and morphologically distinct tumors that occur simultaneously or as metastases from other organs within the thyroid. Medullary and papillary carcinoma co-occurrence is the most frequent. Several theories tried to explain the pathogenic mechanisms underlining collision tumors, including the theory which assumes that one tumor predisposes the other, stem cell theory, and random effect theory, but their combination better explains the origin of these tumors. Hypotheses about common genetic behavior responsible for the pathogenesis have also been suggested, such as the involvement of germline mutation of RET (Rearranged during Transfection) proto-oncogene in medullary thyroid carcinoma and papillary thyroid carcinoma coexistence, but there is controversy on this topic. Management of thyroid collision tumors is challenging owing to the presence of two distinct tumors with different biological aggressiveness, treatments options, and prognosis, and needs to be individualized.
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Affiliation(s)
- Andreea Bojoga
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania; "C.I. Parhon" National Institute of Endocrinology, Bucharest, Romania
| | - Laura Stănescu
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania; "C.I. Parhon" National Institute of Endocrinology, Bucharest, Romania
| | - Corin Badiu
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania; "C.I. Parhon" National Institute of Endocrinology, Bucharest, Romania
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4
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Wang K, Shi N, Yu M, Zhou W, Wang X, Wang C. Anaplastic spindle cell squamous carcinoma arising from classical papillary thyroid carcinoma with foci of columnar cell component: A case report. Tissue Cell 2021; 73:101666. [PMID: 34678532 DOI: 10.1016/j.tice.2021.101666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 09/07/2021] [Accepted: 10/06/2021] [Indexed: 10/20/2022]
Abstract
We report a case of the anaplastic spindle cell squamous carcinoma(SC) arising from classical papillary thyroid carcinoma(PTC) with foci of columnar cell component in a 69-year-old Chinese woman. The tumor of the right lobe was composed of spindle cell SC and PTC. Histologically,the spindle cell SC were arranged into bundles with marked cellular atypia, nuclear pleomorphism and more mitotic figures. The tumor of the left lobe was a PTC without any SC elements,which was composed of two components, namely classical and columnar cell variants PTC. The columnar cell elements occupied more than 20 % of PTC, which showed striking stratification of nuclei with no characteristic nuclei for the classical type of PTC. The patient has not received any other treatment after radical surgery. She had no tumor recurrence and other complications 13 months after operation. Only classical PTC but not columnar cell PTC and SC had been identified in 7 out of 50 excised cervical lymph nodes. In order to clarify the origin of PTC and spindle cell SC, we performed the BRAFV600E(c.1799 T > A) mutational analysis. The results of molecular analysis showed that BRAFV600E(c.1799 T > A) mutation existed in both components, which further confirmed that spindle cell SC was transformed from PTC.
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Affiliation(s)
- Kang Wang
- Department of Pathology, Nanjing Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing 210000, China
| | - Na Shi
- Department of Pathology, Nanjing Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing 210000, China
| | - Miao Yu
- Department of Pathology, Nanjing Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing 210000, China
| | - Wenqian Zhou
- Department of Pathology, Nanjing Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing 210000, China
| | - Xinling Wang
- Department of Pathology, Nanjing Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing 210000, China
| | - Chonggao Wang
- Department of Thyroid and Breast Surgery, Nanjing Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing 210000, China.
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5
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Manzoor D, Balzer BL, Gayhart M, Vail E, Marchevsky AM, Setoodeh R. Anaplastic thyroid carcinoma presenting as laryngotracheal invasive squamous cell carcinoma: A report of two cases and review of the literature. HUMAN PATHOLOGY: CASE REPORTS 2021. [DOI: 10.1016/j.ehpc.2021.200505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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6
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Eszlinger M, Khalil M, Gillmor AH, Huang H, Stewardson P, McIntyre JB, Morrissy S, Paschke R. Histology-based molecular profiling improves mutation detection for advanced thyroid cancer. Genes Chromosomes Cancer 2021; 60:531-545. [PMID: 33749950 DOI: 10.1002/gcc.22949] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 03/17/2021] [Accepted: 03/18/2021] [Indexed: 01/21/2023] Open
Abstract
Advanced cancers frequently show histologic and molecular intratumoral heterogeneity. Therefore, we comprehensively characterized advanced, metastatic, radioiodine-resistant (RAIR) thyroid carcinomas at the molecular level in the context of histologic heterogeneity with the aim to identify potentially actionable mutations that may guide the use of specific tyrosine kinase inhibitor (TKI) treatment. Whole exome sequencing (WES) was applied to 29 macrodissected tissue samples of histologically heterogeneous and homogeneous areas, lymph node and lung metastases from six clinically and histologically well-characterized metastatic RAIR thyroid cancer patients with structural incomplete response to treatment. WES data were analyzed to identify potential driver mutations in oncogenic pathways, copy number alterations, microsatellite instability, mutant-allele tumor heterogeneity, and the relevance of histologic heterogeneity to molecular profiling. In addition to known driver mutations in BRAF, NRAS, EIF1AX, NCOA4-RET, and TERT, further potentially actionable drivers were identified in AKT1, ATM, E2F1, HTR2A, and MLH3. The analysis of the evolutionary history of the mutations and the reconstruction of the molecular phylogeny of the cancers show a remarkable association between histologic and molecular heterogeneity. A comprehensive molecular analysis of the primary tumor guided by histologic analysis may help to better stratify patients for precision medicine approaches. Given the association between the molecular and the histologic heterogeneity, the selection of tumor samples for molecular analysis should be based on meticulous histologic evaluation of the entire tumor.
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Affiliation(s)
- Markus Eszlinger
- Departments of Oncology, Pathology and Laboratory Medicine, Biochemistry and Molecular Biology, and Arnie Charbonneau Cancer Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Institute of Pathology, University Hospital Halle, Halle, Germany
| | - Moosa Khalil
- Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Aaron Hill Gillmor
- Department of Graduate Sciences and Arnie Charbonneau Cancer Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Helen Huang
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Paul Stewardson
- Department of Medical Science and Arnie Charbonneau Cancer Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - John B McIntyre
- Precision Oncology Hub Laboratory, Alberta Health Services, Tom Baker Cancer Centre, Calgary, Alberta, Canada
| | - Sorana Morrissy
- Department of Biochemistry and Molecular Biology, and Arnie Charbonneau Cancer Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Ralf Paschke
- Departments of Medicine, Oncology, Pathology and Laboratory Medicine, Biochemistry and Molecular Biology, and Arnie Charbonneau Cancer Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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7
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Chu MMH, Mirza O, Bishop PW, Pothula V. Primary squamous cell carcinoma of the thyroid gland successfully treated with surgical resection and adjuvant chemoradiotherapy. BMJ Case Rep 2021; 14:14/3/e241209. [PMID: 33649031 PMCID: PMC7929853 DOI: 10.1136/bcr-2020-241209] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A 57-year-old woman presented with a 3-month history of an enlarging thyroid mass causing breathlessness and dysphagia. Cross-sectional imaging showed a thyroid tumour infiltrating the trachea and abutting the oesophagus. She underwent panendoscopy, total thyroidectomy and planned tracheal resection, but due to intraoperative findings, a staged procedure was planned instead. Histological analysis revealed a poorly differentiated squamous cell carcinoma (SCC) which was positive on paired box gene 8 (PAX8) immunostaining, suggesting a diagnosis of primary thyroid SCC. She subsequently underwent total laryngectomy and bilateral neck dissections followed by radiotherapy with concurrent cisplatin chemotherapy. The patient remains disease-free 22 months after treatment. Median overall survival is 10 months for macroscopically completely resected tumours. PAX8 immunostaining is a novel technique which helps with the diagnostic challenge of distinguishing between primary thyroid SCC and SCC metastatic to the thyroid from extrathyroidal sites. Complete surgical resection with adjuvant chemoradiotherapy may result in a favourable outcome despite conflicting reports in the literature.
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Affiliation(s)
- Michael M H Chu
- Department of Otolaryngology, Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK
| | - Omar Mirza
- Department of Head and Neck Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Paul William Bishop
- Department of Pathology, Manchester University NHS Foundation Trust, Manchester, Greater Manchester, UK
| | - Vijay Pothula
- Department of Otolaryngology, Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK
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8
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Ragazzi M, Torricelli F, Donati B, Ciarrocchi A, de Biase D, Tallini G, Zanetti E, Bisagni A, Kuhn E, Giordano D, Frasoldati A, Piana S. Coexisting well-differentiated and anaplastic thyroid carcinoma in the same primary resection specimen: immunophenotypic and genetic comparison of the two components in a consecutive series of 13 cases and a review of the literature. Virchows Arch 2021; 478:265-281. [PMID: 32683537 DOI: 10.1007/s00428-020-02891-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 06/30/2020] [Accepted: 07/07/2020] [Indexed: 02/08/2023]
Abstract
Anaplastic carcinoma (AC) is a rare but highly aggressive form of thyroid cancer. It mostly arises on a background of pre-existing well-differentiated cancer (WDC); however, whether it evolves directly from a WDC or originates as a second independent neoplasm is still to be defined. To obtain further insights into these mechanisms, we performed morphological, immunohistochemical, and next-generation sequencing analyses to compare AC and its associated WDC in a subset of 13 surgically resected specimens. Histologically, most WDC were of aggressive subtypes. Papillary carcinomas (8 cases; 62%) were tall cell (4/8), columnar (1/8), classic with hobnail features (1/8), classic and follicular variant in the remaining 2 cases; Hürthle cell and follicular carcinomas were present in 5 (38%) and in 1 (8%) patient, respectively. One patient harbored both a PTC, follicular variant, and a Hürthle cell carcinoma. We did not find any correlation between a histotype of WDC and a specific anaplastic growth pattern. Immunohistochemically, ACs retained pankeratin/PAX8 expression but with significantly lower levels than WDCs, and they tended to lose TTF1 expression, as can be expected within a dedifferentiation process. In addition, AC showed a more frequent expression of p63 and/or SMA, a mutated pattern of p53, and an abnormal expression of p16. Genetic analysis showed that the number of mutations was higher in AC than in the associated WDC, confirming a role of the progressive accumulation of genetic damage in this transition. We observed that mutations found in the WDCs were consistently identified in the anaplastic counterparts, further supporting the hypothesis of a developmental link.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Biomarkers, Tumor/analysis
- Biomarkers, Tumor/genetics
- Cell Differentiation
- Female
- Genetic Predisposition to Disease
- High-Throughput Nucleotide Sequencing
- Humans
- Immunohistochemistry
- Immunophenotyping
- Male
- Middle Aged
- Molecular Diagnostic Techniques
- Mutation
- Neoplasms, Complex and Mixed/chemistry
- Neoplasms, Complex and Mixed/genetics
- Neoplasms, Complex and Mixed/pathology
- Phenotype
- Predictive Value of Tests
- Thyroid Carcinoma, Anaplastic/chemistry
- Thyroid Carcinoma, Anaplastic/genetics
- Thyroid Carcinoma, Anaplastic/pathology
- Thyroid Carcinoma, Anaplastic/surgery
- Thyroid Neoplasms/chemistry
- Thyroid Neoplasms/genetics
- Thyroid Neoplasms/pathology
- Thyroid Neoplasms/surgery
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Affiliation(s)
- Moira Ragazzi
- Pathology Unit, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS di Reggio Emilia, Viale Risorgimento 80, 42123, Reggio Emilia, Italy
| | - Federica Torricelli
- Laboratory of Translational Research, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Benedetta Donati
- Laboratory of Translational Research, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Alessia Ciarrocchi
- Laboratory of Translational Research, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Dario de Biase
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
| | - Giovanni Tallini
- Molecular Diagnostic Unit, Department of Medicine (Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale), Azienda USL di Bologna, University of Bologna, Bologna, Italy
| | - Eleonora Zanetti
- Pathology Unit, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS di Reggio Emilia, Viale Risorgimento 80, 42123, Reggio Emilia, Italy
| | - Alessandra Bisagni
- Pathology Unit, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS di Reggio Emilia, Viale Risorgimento 80, 42123, Reggio Emilia, Italy
| | - Elisabetta Kuhn
- Division of Pathology, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Milan, Italy
| | - Davide Giordano
- Otolaryngology Unit, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Andrea Frasoldati
- Endocrinology Unit, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Simonetta Piana
- Pathology Unit, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS di Reggio Emilia, Viale Risorgimento 80, 42123, Reggio Emilia, Italy.
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9
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Agilinko J, Kueh TJ, Smart L, Shakeel M. Primary thyroid squamous cell carcinoma: a challenging management problem. BMJ Case Rep 2021; 14:e238560. [PMID: 33509876 PMCID: PMC7845689 DOI: 10.1136/bcr-2020-238560] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2020] [Indexed: 01/30/2023] Open
Abstract
Primary thyroid squamous cell carcinoma (SCC) is a rare and highly aggressive cancer. Diagnostic work-up encompasses cervical ultrasonography, tissue biopsy and CT scan. Surgery, radiotherapy and chemotherapy are the available treatment modalities. With a mean survival rate of 7 months reported in the literature, our patient is alive 2 years after successful treatment of her advanced primary thyroid SCC with surgery and radiotherapy.
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Affiliation(s)
- Joshua Agilinko
- Department of Otolaryngology-Head and Neck Surgery, Aberdeen Royal Infirmary, Aberdeen, UK
| | - Tze Jun Kueh
- Department of Pathology, Aberdeen Royal Infirmary, Aberdeen, UK
| | - Louise Smart
- Department of Pathology, Aberdeen Royal Infirmary, Aberdeen, UK
| | - Muhammad Shakeel
- Department of Otolaryngology-Head and Neck Surgery, Aberdeen Royal Infirmary, Aberdeen, UK
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10
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Torrez M, Braunberger RC, Yilmaz E, Agarwal S. Primary squamous cell carcinoma of thyroid with a novel BRAF mutation and High PDL-1 expression: A case report with treatment implications and review of literature. Pathol Res Pract 2020; 216:153146. [PMID: 32853962 DOI: 10.1016/j.prp.2020.153146] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 07/07/2020] [Accepted: 07/24/2020] [Indexed: 11/28/2022]
Abstract
Primary squamous cell carcinoma of thyroid (SCC-T) is an extremely rare, aggressive neoplasm with median survival of 9 months. Pure squamous morphology with absence of other cell types is required for diagnosis of SCC-T. Clinically, SCC-T behaves like anaplastic thyroid carcinoma (ATC) showing rapid growth, and extra thyroidal extension. We report a 91-year-old woman presenting with an enlarging thyroid mass and accompanying dysphagia and hoarseness. Fine needle aspiration revealed hypercellular specimen with large, pleomorphic, malignant cells. Intraoperative assessment revealed an inoperable tumor involving both thyroid lobes and extensively infiltrating surrounding soft tissues. A subtotal thyroidectomy was performed. Histology revealed squamous cell carcinoma replacing native thyroid tissue and infiltrating adjacent skeletal muscle. Lymphovascular and perineural invasion were present. Immunohistochemistry showed tumor cells positive for CK5-p40, Pax-8, TTF-1 and negative for thyroglobulin. P53 expression by IHC was high and Ki-67 proliferation index was > 90 %. (Next generation sequencing revealed a novel BRAF mutation (BRAF c.1799 T > A; 1801_1812del) along with TP53 and TERT mutations. PDL-1 immunohistochemistry showed positive expression in tumor cells (>80%), making patient also amenable to anti-PDL-1 immunotherapy. Patient was treated with BRAF inhibitor therapy with initial relief but eventually was put on hospice care due to increasing intolerance to therapy. This case represents a rare thyroid malignancy with a unique molecular signature consisting of a novel BRAF mutation [previously not described in SCC-T or ATC], associated with TERT-TP53 mutations. Further, importance of PDL-1 testing as a prognostic marker and as a guide to immunotherapy in refractory tumors is discussed.
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Affiliation(s)
- Mary Torrez
- Department of Pathology, University of New Mexico School of Medicine, Albuquerque, New Mexico, United States
| | - Ryan C Braunberger
- Department of Pathology, University of New Mexico School of Medicine, Albuquerque, New Mexico, United States
| | - Emrullah Yilmaz
- Department of Oncology/ Hematology, University of New Mexico Comprehensive Cancer Center, Albuquerque, New Mexico, United States
| | - Shweta Agarwal
- Department of Pathology, University of New Mexico School of Medicine, Albuquerque, New Mexico, United States.
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11
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Othman RT, Baizeed AMA, Mohammed AA. Squamous cell carcinoma of the thyroid gland in an elderly female presenting as a rapidly enlarging thyroid mass. Int J Surg Case Rep 2020; 70:119-122. [PMID: 32416481 PMCID: PMC7229238 DOI: 10.1016/j.ijscr.2020.04.064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 04/18/2020] [Accepted: 04/21/2020] [Indexed: 11/30/2022] Open
Abstract
Squamous cell carcinoma of the thyroid gland is an extremely rare tumor. It may be primary tumor within the thyroid gland or as a component of anaplastic or undifferentiated tumors. The tumor has a very aggressive clinical behavior with a median survival of few months.
Background Squamous cell carcinoma of the thyroid gland is an extremely rare tumor with a very aggressive clinical behavior and poor prognosis. The tumor may arise as a primary tumor within the thyroid gland or as a component of anaplastic or undifferentiated thyroid tumors. Case presentation A 70-year-old lady with history of long standing multinodular goiter presented with progressive enlargement of a midline nodule for 3 months which was associated with dyspnea and dry cough. The mass was hard and fixed. The voice was normal, other parts of the general examination were unremarkable. Fine needle aspiration was done for the mass which revealed malignant cells mixed with inflammatory cells. During surgery there was a hard and fixed mass arising from the isthmus of the thyroid gland that was locally invading, complete excision was not possible, debulking was done. Histopathology showed moderately differentiated squamous cell carcinoma of the thyroid gland. The tumor underwent local progression 6 months later and the patient was sent for radiotherapy. Conclusion When thyroid tumor is advanced at time of diagnosis, radiotherapy is the main form of treatment which may induce reduction in the size of the tumor and decrease pain, radiotherapy may also be given on neoadjuvant bases which may render resection possible in some patients. The tumor is usually not responsive to chemotherapy. The overall survival is uniformly poor regardless of the primary form of treatment, the median survival of the patients from the time of diagnosis is few months in most cases.
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Affiliation(s)
- Ramadhan T Othman
- Department of Internal Medicine, College of Medicine, University of Duhok, Kurdistan Region, Iraq
| | | | - Ayad Ahmad Mohammed
- Department of Surgery, College of Medicine, University of Duhok, Kurdistan Region, Iraq.
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12
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Gadde R, Tafe LJ, Tsapakos MJ, Liu X. A case report of papillary thyroid carcinoma dedifferentiated to squamous cell carcinoma presenting as a lung metastasis: A potential diagnostic pitfall. Diagn Cytopathol 2020; 48:581-585. [PMID: 32271487 DOI: 10.1002/dc.24422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 03/04/2020] [Accepted: 03/24/2020] [Indexed: 11/05/2022]
Abstract
Papillary thyroid carcinoma (PTC) tall cell variant (TCV) with squamous dedifferentiation is a rare entity. We present a case of 90-year-old woman who initially had a 2.8 cm conventional PTC in right lobe of thyroid who, couple decades later, had metastatic dedifferentiated PTC to right neck lymph nodes level II and IV with tall cell features; to right level IV and V lymph nodes with tall cell and squamous components, which recently presented exclusively as squamous cell carcinoma (SCC) metastasizing to lung. The squamous component in the lymph node and SCC in the lung were both positive for squamous marker p63 and PTC markers TTF1, PAX-8 and BRAF V600E while negative for thyroglobulin and p16. The papillary component was positive for TTF-1, BRAF V600E and P63 (majority); negative for thyroglobulin and p16. Final diagnoses were rendered based on combination of cytological features and immunohistochemical profiles. This report highlights the utilization of current biomarkers to distinguish between metastatic dedifferentiated PTC with squamous features and primary lung SCC, as well as the importance of recognizing this rare entity.
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Affiliation(s)
- Ramya Gadde
- Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA.,Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Laura J Tafe
- Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA.,Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Michael J Tsapakos
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA.,Department of Radiology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Xiaoying Liu
- Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA.,Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
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13
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Thewjitcharoen Y, Krittiyawong S, Butadej S, Nakasatien S, Polchart S, Junyangdikul P, Kanchanapituk A, Himathongkam T. De-differentiation of papillary thyroid carcinoma into squamous cell carcinoma in an elderly patient: A case report. Medicine (Baltimore) 2020; 99:e19892. [PMID: 32312017 PMCID: PMC7440287 DOI: 10.1097/md.0000000000019892] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
RATIONALE The unpredictability of thyroid cancer can be striking, as the disease may rapidly progress to death in some individuals. Herein, we reported a rare case of aggressive papillary thyroid cell carcinoma (PTC) in an elderly patient de-differentiated into squamous cell carcinoma (SCC). PATIENT CONCERNS We describe a case of a 79-year-old Thai woman presented with hoarseness and neck mass for 2 months and she had been diagnosed with a 3-cm papillary thyroid carcinoma (PTC) in the right side of the thyroid gland. Later on PTC de-differentiated into SCC within 3 years after initial presentation. DIAGNOSIS De-differentiation from papillary thyroid carcinoma to squamous cell carcinoma. INTERVENTIONS The patient underwent a total thyroidectomy at the initial hospital and received high dose radioactive iodine (RAI) treatment at our hospital 1 month following the surgery and then was lost to follow-up. Two years later she came back with new development of right solid-cystic neck mass which was found to be recurrent PTC. A radical neck dissection was done and another high dose RAI treatment was given. However, she developed recurrent mass with tenderness at the site above previous solid cystic mass 6 months later. Re-exploration of the neck mass revealed an inflamed midline mass 2 cm with enlarged right lateral cervical lymph nodes. OUTCOMES A histopathological examination of the midline neck mass showed poorly differentiated SCC with lymphatic invasion. The intermingling of two morphologically distinct tumors, a typical PTC and a poorly differentiated SCC, had been identified in 1 out of 14 excised cervical lymph nodes. The patient underwent external beam radiation without chemotherapy. She is still in stable condition at 18 months post-treatment. LESSONS This case clearly demonstrated that SCC transformed from a pre-existing PTC. The clinician should consider a possible transformation of papillary thyroid cancer into more aggressive histological types in elderly patients who present with rapidly progressive clinical behavior. However, some patients could have long-term survival if the tumor did not transform into anaplastic thyroid cancer.
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MESH Headings
- Aged
- Asian People/ethnology
- Carcinoma, Papillary/pathology
- Carcinoma, Papillary/radiotherapy
- Carcinoma, Papillary/surgery
- Carcinoma, Squamous Cell/pathology
- Carcinoma, Squamous Cell/radiotherapy
- Carcinoma, Squamous Cell/surgery
- Cell Differentiation
- Female
- Humans
- Iodine Radioisotopes/therapeutic use
- Lost to Follow-Up
- Lymph Node Excision/methods
- Neck Dissection/methods
- Neoplasm Recurrence, Local/pathology
- Neoplasm Recurrence, Local/surgery
- Thyroid Cancer, Papillary/pathology
- Thyroid Cancer, Papillary/radiotherapy
- Thyroid Cancer, Papillary/surgery
- Thyroid Gland/pathology
- Thyroid Neoplasms/pathology
- Thyroid Neoplasms/radiotherapy
- Thyroid Neoplasms/surgery
- Thyroidectomy/methods
- Treatment Outcome
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Affiliation(s)
| | | | | | | | | | - Pairoj Junyangdikul
- Division of Anatomical and Clinical Pathology, Samitivej Srinakarin Hospital, Bangkok, Thailand
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14
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Wang SS, Ye DX, Wang B, Xie C. The Expressions of Keratins and P63 in Primary Squamous Cell Carcinoma of the Thyroid Gland: An Application of Raman Spectroscopy. Onco Targets Ther 2020; 13:585-591. [PMID: 32021300 PMCID: PMC6980845 DOI: 10.2147/ott.s229436] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Accepted: 12/05/2019] [Indexed: 12/24/2022] Open
Abstract
Purpose Primary squamous cell carcinoma is a rare malignancy in the thyroid gland (SCCTh). The overall prognosis of this carcinoma is poor. This study aimed to explore the application of Raman spectroscopy in investigating the expression of CK5/6 and P63 in SCCTh. Patients and Methods Tissues of the SCCTh and adjacent normal thyroid, as well as blood serum, were collected from a patient with pathology-confirmed SCCTh. Whole genome sequencing analysis was performed with the tissue of the SCCTh. The expressions of keratins and TP53 family gene were investigated by the Raman spectroscopy in tissues of the SCCTh and adjacent normal thyroid. The serum was also investigated by the Raman spectroscopy for the expression of keratins and TP53 family gene. Results The whole genome sequencing analysis identified the mutation of the TP53 gene (42%) in the tissues of SCCTh. Accordingly, the Raman spectra analyses showed higher expression of keratins and TP53 family gene in the tissues of SCCTh compared with that in the adjacent normal thyroid. Raman spectra analyses of the serum of the patient also showed the expressions of the keratins and TP53 family gene. Conclusion The expressions of the keratins and TP53 are different in the tissues of SCCTh and adjacent normal thyroid, and the difference could be identified with high sensitivity by the Raman spectra analyses.
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Affiliation(s)
- Si-Si Wang
- Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, The People's Republic of China
| | - Dao-Xiong Ye
- Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, The People's Republic of China
| | - Bo Wang
- Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, The People's Republic of China
| | - Chao Xie
- Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, The People's Republic of China
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15
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Tewari S, Khunteta N. Primary squamous cell carcinoma thyroid: A rare case. JOURNAL OF HEAD & NECK PHYSICIANS AND SURGEONS 2020. [DOI: 10.4103/jhnps.jhnps_36_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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16
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Wang W, Ouyang Q, Meng C, Jing L, Li X. Treatment optimization and prognostic considerations for primary squamous cell carcinoma of the thyroid. Gland Surg 2019; 8:683-690. [PMID: 32042676 DOI: 10.21037/gs.2019.11.07] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Background Primary squamous cell carcinoma of the thyroid (PSCCT) is a rare aggressive malignancy that usually presents in an advanced stage and has a poor prognosis. Our study aimed to investigate the clinical characteristics, treatment, and prognosis of PSCCT. Methods We retrospectively reviewed the medical information of patients with PSCCT diagnosed from January 2006 to May 2018 at Xiangya Hospital. Survival analysis was conducted using the Kaplan-Meier method, and Log-Rank tests were performed for statistical testing. Results We identified 12 patients with PSCCT (nine males and three females), accounting for only 0.19% of all thyroid cancer diagnosed during this time period. The median age of these patients was 59.5 years old and their symptoms included neck masses (n=5), hoarseness (n=2), dyspnea (n=1), dysphagia (n=1) and neck pain (n=1). Four patients were in stage IVA, five were stage IVB, and three patients were stage IVC. Six patients underwent comprehensive treatment (surgery + radiotherapy or surgery + radiotherapy + chemotherapy) and the remaining patients received radiotherapy and/or chemotherapy. The 6-month survival rate was 66.7%, compared to a 1-year survival rate of 25.0%, with a median overall survival time was 10.5 months. Kaplan-Meier analysis showed that the comprehensive treatment was superior to radiotherapy and/or chemotherapy (P=0.003). Conclusions PSCCT is a rare type of thyroid cancer that is highly invasive and has a poor prognosis. We show that a comprehensive treatment plan can significantly improve patient survival.
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Affiliation(s)
- Wenlong Wang
- General Surgery Department, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Qianhui Ouyang
- General Surgery Department, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Chaoyang Meng
- General Surgery Department, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Lanyu Jing
- General Surgery Department, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Xinying Li
- General Surgery Department, Xiangya Hospital, Central South University, Changsha 410008, China
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17
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The Utility of Immunohistochemistry in Differentiating Metastatic Primary Squamous Cell Carcinoma of the Thyroid from a Primary Lung Squamous Cell Carcinoma. Case Rep Endocrinol 2019; 2019:8641267. [PMID: 31772786 PMCID: PMC6854985 DOI: 10.1155/2019/8641267] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 07/24/2019] [Accepted: 08/28/2019] [Indexed: 12/14/2022] Open
Abstract
Primary squamous cell carcinoma of the thyroid gland (PSCCTh) and anaplastic thyroid carcinoma with extensive squamous differentiation are rare entities which pose a diagnostic challenge in determining the primary site when presented as metastases. The difficulty in confirming a thyroid primary is further compounded by the aggressive nature of these tumours which frequently present at advanced stages. We present a case in which the patient presented with a thyroid mass and a lung mass simultaneously. The risk of misinterpreting the site of primary tumour as lung is greatly increased because squamous cell carcinoma of lung is much more common than its thyroid counterpart. This case highlights the effectiveness of PAX-8 stain in determining the primary site of tumour when squamous cell carcinoma is found in both lung and thyroid gland.
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18
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Dennis K, O'Neil M, Harrington A. Not all neck mass fine-needle aspirations with squamous cells are squamous cell carcinoma; report of a case of recurrent thyroid carcinoma with papillary and squamous components. Cytojournal 2018; 15:23. [PMID: 30294355 PMCID: PMC6161500 DOI: 10.4103/cytojournal.cytojournal_19_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 06/11/2017] [Indexed: 11/04/2022] Open
Abstract
We report a case of a 65-year-old female who had a total thyroidectomy 12 years ago for papillary thyroid carcinoma (PTC) who presented with a recurrent thyroid bed mass. Fine-needle aspiration biopsy yielded malignant cells, consistent with squamous cell carcinoma (SCCa). Surgical resection was performed, and histologic evaluation of the mass showed mixed PTC and SCCa. The tumor cells were positive for BRAF V600E mutation. Thyroid carcinomas with admixed papillary carcinoma and SCCa are rare and are associated with aggressive behavior, high rates of metastasis, and poor outcomes. Although SCCa presenting as a neck mass is relatively common, clinical history and appropriate workup are essential for accurate diagnosis and determination of origin.
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Affiliation(s)
- Katie Dennis
- Address: Department of Pathology and Laboratory Medicine, University of Kansas School of Medicine, 3901 Rainbow Blvd, Kansas City, KS 66160, USA
| | - Maura O'Neil
- Address: Department of Pathology and Laboratory Medicine, University of Kansas School of Medicine, 3901 Rainbow Blvd, Kansas City, KS 66160, USA
| | - Anthony Harrington
- Address: Department of Pathology and Laboratory Medicine, University of Kansas School of Medicine, 3901 Rainbow Blvd, Kansas City, KS 66160, USA
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19
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Koyama S, Fujiwara K, Nosaka K, Fukuhara T, Morisaki T, Miyake N, Kitano H, Takeuchi H. Immunohistochemical Features of Primary Pure Squamous Cell Carcinoma in the Thyroid: An Autopsy Case. Case Rep Oncol 2018; 11:418-424. [PMID: 30057536 PMCID: PMC6062687 DOI: 10.1159/000490410] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 05/25/2018] [Indexed: 12/18/2022] Open
Abstract
Primary squamous cell carcinoma (SCC) in the thyroid is extremely rare and has been reported in < 1% of all thyroid cancer cases. Primary SCC in the thyroid was thought to be a transitional form derived from adenocarcinomas; therefore, the majority of reported cases have focused on the conjunction with other histological adenocarcinomas. A 73-year-old male presented to our hospital with bilateral vocal fold palsy and an anterior neck mass. Ultrasound sonography revealed a bulky tumor in the thyroid and bilateral cervical lymphadenopathy. We performed fine-needle aspiration cytology from the thyroid tumor, which revealed SCC. Positron emission tomography/computed tomography showed distant metastases in the lungs, mediastinal lymph nodes, and vertebra. We diagnosed the patient as having stage IVC SCC in the thyroid and administered weekly paclitaxel. Four and a half months after treatment initiation, the tumor progression resulted in aspiration pneumonia, which proved fatal. We performed an autopsy in accordance with the patient's wishes. Pathological findings revealed that all carcinomas in the thyroid, cervical lymph nodes, and lungs were pure SCCs. Immunohistochemical examinations for PAX8, thyroglobulin, and TTF-1 were all negative. Differentiated thyroid carcinomas have 3 major positive markers - PAX8, thyroglobulin, and TTF-1 –, and PAX8 is also sometimes positive for SCC in the thyroid. PAX8 positivity of SCC in the thyroid might, however, be associated with conjunction with other histological adenocarcinomas such as papillary or follicular thyroid carcinoma; therefore, pure SCC in the thyroid might be negative for PAX8.
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Affiliation(s)
- Satoshi Koyama
- Division of Otolaryngology, Head and Neck Surgery, Department of Medicine of Sensory and Motor Organs, Tottori University Faculty of Medicine, Yonago, Japan
| | - Kazunori Fujiwara
- Division of Otolaryngology, Head and Neck Surgery, Department of Medicine of Sensory and Motor Organs, Tottori University Faculty of Medicine, Yonago, Japan
| | - Kanae Nosaka
- Division of Organ Pathology, Department of Microbiology and Pathology, Tottori University Faculty of Medicine, Yonago, Japan
| | - Takahiro Fukuhara
- Division of Otolaryngology, Head and Neck Surgery, Department of Medicine of Sensory and Motor Organs, Tottori University Faculty of Medicine, Yonago, Japan
| | - Tsuyoshi Morisaki
- Division of Otolaryngology, Head and Neck Surgery, Department of Medicine of Sensory and Motor Organs, Tottori University Faculty of Medicine, Yonago, Japan
| | - Naritomo Miyake
- Division of Otolaryngology, Head and Neck Surgery, Department of Medicine of Sensory and Motor Organs, Tottori University Faculty of Medicine, Yonago, Japan
| | - Hiroya Kitano
- Division of Otolaryngology, Head and Neck Surgery, Department of Medicine of Sensory and Motor Organs, Tottori University Faculty of Medicine, Yonago, Japan.,Center for Head and Neck Surgery, Kusatsu General Hospital, Kusatsu, Japan
| | - Hiromi Takeuchi
- Division of Otolaryngology, Head and Neck Surgery, Department of Medicine of Sensory and Motor Organs, Tottori University Faculty of Medicine, Yonago, Japan
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20
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Beninato T, Kluijfhout WP, Drake FT, Khanafshar E, Gosnell JE, Shen WT, Duh QY, Suh I. Squamous differentiation in papillary thyroid carcinoma: a rare feature of aggressive disease. J Surg Res 2018; 223:39-45. [DOI: 10.1016/j.jss.2017.10.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 09/15/2017] [Accepted: 10/12/2017] [Indexed: 10/18/2022]
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21
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Yasuoka H, Nakamura Y, Yoshida KI, Shimo T, Tori M, Matsui Y, Sakamaki Y, Tsujimoto M. A rare case of ectopic papillary thyroid carcinoma transformed into squamous cell carcinoma. Pathol Int 2018; 68:246-250. [PMID: 29451347 DOI: 10.1111/pin.12649] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 01/09/2018] [Indexed: 12/29/2022]
Abstract
A rare case of a metastatic ectopic papillary thyroid carcinoma (PTC) of the lung that transformed into a squamous cell carcinoma (SCC) that resembles pulmonary SCC is reported. A subcutaneous ectopic PTC in the left anterior neck area, together with a normal thyroid gland, were excised. The ectopic PTC showed thyroglobulin, TTF-1 and PAX-8 immunoreactivity and a BRAF V600E mutation. During the post-operative follow-up period, a rapidly growing 2 cm nodular lesion in the lower left lobe of the lung was detected. The lung tumor consisted of solid sheets and nests of squamous cells but without the nuclear features of PTC. Neither papillary nor follicular structures of cancer cells were identified. Carcinoma cells were positive for TTF-1, PAX-8, p40, CK14, and p63, while showing a high Ki-67 labeling index and a BRAF V600E mutation. These results support our interpretation of a PTC that originated from ectopic thyroid tissue in the left anterior neck and that developed a lung metastasis showing squamous cell differentiation.
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Affiliation(s)
| | - Yasushi Nakamura
- Department of Pathology, Osaka Cytopathological Laboratory, Osaka
| | - Ken-Ichi Yoshida
- Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo
| | - Toshiro Shimo
- Department of Endocrine Surgery, Osaka Police Hospital
| | - Masayuki Tori
- Department of Endocrine Surgery, Osaka Police Hospital
| | - Yuuki Matsui
- Department of Thoracic Surgery, Osaka Police Hospital, Osaka, Japan
| | - Yasushi Sakamaki
- Department of Thoracic Surgery, Osaka Police Hospital, Osaka, Japan
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22
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Fassan M, Pennelli G, Pelizzo MR, Rugge M. Primary Squamous Cell Carcinoma of the Thyroid: Immunohistochemical Profile and Literature Review. TUMORI JOURNAL 2018; 93:518-21. [DOI: 10.1177/030089160709300522] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Squamous cell carcinoma accounts for 1% of primary thyroid malignancies and is characterized by a rapidly unfavorable outcome. Case Presentation A 64-year-old woman presented with a painless mass in the left neck, coexisting with thyroid goiter. Total thyroidectomy with lymphadenectomy was performed and a primary thyroid squamous cell cancer was confirmed histo-logically after excluding any other possible primary malignancies. The tumor's immunohistochemical profile was explored using a large panel of antibodies. The tumor featured a positive immunoreaction to cytokeratins 7–19 and to squamous cell carcinoma antigen. Low-molecular-weight cytokeratins 5–6 and epithelial membrane antigen were also expressed. The neoplasm's proliferative index (Mib1) was 60%. No immunostaining was detected for cytokeratins 10–20, thyroglobulin, TTF-1, CD5, galectin-3 or p53. Conclusions This case of primary thyroid squamous cell carcinoma immunohistochemically profiled using a large panel of immunoreactions may offer useful information on the histological differentiation of thyroid squamous cell carcinoma from other (uncommon) thyroid carcinomas and the distinction between primary and secondary thyroid cancers.
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Affiliation(s)
- Matteo Fassan
- Pathology Unit, Department of Medical Diagnostic Sciences and Special Therapies
| | - Gianmaria Pennelli
- Pathology Unit, Department of Medical Diagnostic Sciences and Special Therapies
- Istituto Oncologico Veneto (IOV), IRCCS, Padua, Italy
| | - Maria Rosa Pelizzo
- Surgery Unit, Department of Medical and Surgical Sciences, University of Padua, Padua
- Istituto Oncologico Veneto (IOV), IRCCS, Padua, Italy
| | - Massimo Rugge
- Pathology Unit, Department of Medical Diagnostic Sciences and Special Therapies
- Istituto Oncologico Veneto (IOV), IRCCS, Padua, Italy
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23
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Squamous Cell Carcinoma of the Thyroid as a Result of Anaplastic Transformation from BRAF-Positive Papillary Thyroid Cancer. Case Rep Oncol Med 2017; 2017:4276435. [PMID: 29158933 PMCID: PMC5660805 DOI: 10.1155/2017/4276435] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 08/17/2017] [Accepted: 09/14/2017] [Indexed: 11/17/2022] Open
Abstract
Papillary thyroid carcinoma (PTC) is the most common malignant neoplasm of the thyroid. Majority of the PTC carries an excellent prognosis. However, patients with tall cell variant (TCV) of papillary thyroid carcinoma have a worse prognosis than those with the classic variant. On the other hand, squamous cell carcinoma of the thyroid (SCT) is an unusual neoplasm thought to arise as a primary tumor or as a component of an anaplastic or undifferentiated carcinoma. We report a patient with TCV of PTC presenting years later with squamous transformation. In addition, the patient was found to have BRAF mutation. Such dedifferentiation is considered to be a rare phenomenon and has been reported only in the form of case reports in the literature. The relationship between BRAFV600E mutation and squamous cell transformation of papillary thyroid cancer is unknown at this time. Meticulous pathology is needed to identify such variants. Our patient responded to treatment with concurrent chemotherapy with carboplatin and paclitaxel along with radiation.
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24
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Struller F, Senne M, Falch C, Kirschniak A, Konigsrainer A, Muller S. Primary squamous cell carcinoma of the thyroid: Case report and systematic review of the literature. Int J Surg Case Rep 2017. [PMID: 28633125 PMCID: PMC5479948 DOI: 10.1016/j.ijscr.2017.06.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Primary squamous cell cancer (PSCC) of thyroid is a rare malignancy with poor prognosis. It is mandatory to exclude secondary involvement of the thyroid by panendoscopy, CT-scan and immunohistochemical analysis. As treatment surgery, radiation and rarely chemotherapy is employed. METHODS A systematic review of the literature was conducted searching medline and embase database using the medical subject headings "primary squamous cell carcinoma of thyroid" and "primary squamous cell cancer of thyroid", for articles published until April 2016 (n=1733). Of interest were the used treatment modalities and survival outcomes. RESULTS A total of 35 publications reporting on 50 cases including ours were finally analyzed. A curative treatment approach was described in 24 patients (48%). Additional radiotherapy, chemotherapy or radiochemotherapy was applied in 17, 7 and 7 patients respectively. Median overall survival was 6 months [range 0-48] for 47 patients. Disease free survival was only achieved in 8 patients with disease limited to the thyroid gland, complete surgical resection and additional radiotherapy or radiochemotherapy [reported median 20 months; range 12-48]. CONCLUSION Reported disease free survival of PSCC of the thyroid was only achieved in patients with complete surgical resection in combination with adjuvant radio- and/or chemotherapy. However long term survival has not been reported in the literature yet.
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Affiliation(s)
- Florian Struller
- Clinic for Visceral, General and Transplant Surgery, Tuebingen University Hospital, Germany
| | - Moritz Senne
- Clinic for Visceral, General and Transplant Surgery, Tuebingen University Hospital, Germany
| | - Claudius Falch
- Clinic for Visceral, General and Transplant Surgery, Tuebingen University Hospital, Germany
| | - Andreas Kirschniak
- Clinic for Visceral, General and Transplant Surgery, Tuebingen University Hospital, Germany
| | - Alfred Konigsrainer
- Clinic for Visceral, General and Transplant Surgery, Tuebingen University Hospital, Germany
| | - Sven Muller
- Clinic for Visceral, General and Transplant Surgery, Tuebingen University Hospital, Germany.
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25
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26
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Au JK, Alonso J, Kuan EC, Arshi A, St John MA. Primary Squamous Cell Carcinoma of the Thyroid: A Population-Based Analysis. Otolaryngol Head Neck Surg 2017; 157:25-29. [PMID: 28397584 DOI: 10.1177/0194599817698436] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Objectives To analyze the epidemiology and describe the prognostic indicators of patients with primary squamous cell carcinoma of the thyroid. Study Design and Setting Retrospective cohort study based on a national database. Methods The US National Cancer Institute's SEER registry (Surveillance, Epidemiology, and End Results) was reviewed for patients with primary squamous cell carcinoma of the thyroid from 1973 to 2012. Study variables included age, sex, race, tumor size, tumor grade, regional and distant metastases, and treatment modality. Survival measures included overall survival (OS) and disease-specific survival (DSS). Results A total of 199 cases of primary squamous cell carcinoma of the thyroid were identified. Mean age at diagnosis was 68.1 years; 58.3% were female; and 79.4% were white. Following diagnosis, 46.3% of patients underwent surgery; 55.7%, radiation therapy; and 45.8%, surgery with radiation therapy. Kaplan-Meier analysis demonstrated OS and DSS of 16% and 21% at 5 years, respectively. Median survival after diagnosis was 9.1 months. Multivariate Cox regression analysis showed that predictors of OS and DSS included age ( P < .001, P < .001, respectively), tumor grade ( P < .001, P = .001), and tumor size ( P < .001, P = .001). Surgical management was a predictor of OS but not DSS. Conclusion Squamous cell carcinoma of the thyroid is a rare malignancy with a very poor prognosis. Surgical resection confers an overall survival benefit. Age, tumor grade, and tumor size are predictors of OS and DSS.
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Affiliation(s)
- Joshua K Au
- 1 Department of Head and Neck Surgery, UCLA Medical Center, Los Angeles, California, USA.,2 Head and Neck Cancer Program, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Jose Alonso
- 1 Department of Head and Neck Surgery, UCLA Medical Center, Los Angeles, California, USA
| | - Edward C Kuan
- 1 Department of Head and Neck Surgery, UCLA Medical Center, Los Angeles, California, USA.,2 Head and Neck Cancer Program, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Armin Arshi
- 1 Department of Head and Neck Surgery, UCLA Medical Center, Los Angeles, California, USA
| | - Maie A St John
- 1 Department of Head and Neck Surgery, UCLA Medical Center, Los Angeles, California, USA.,2 Head and Neck Cancer Program, David Geffen School of Medicine, University of California, Los Angeles, California, USA.,3 Jonsson Comprehensive Cancer Center, David Geffen School of Medicine, University of California, Los Angeles, USA
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27
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Anaplastic Spindle Cell Squamous Carcinoma Arising from Tall Cell Variant Papillary Carcinoma of the Thyroid Gland: A Case Report and Review of the Literature. Case Rep Endocrinol 2017; 2017:4581626. [PMID: 28484653 PMCID: PMC5397626 DOI: 10.1155/2017/4581626] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 03/22/2017] [Indexed: 12/18/2022] Open
Abstract
Tall cell variant (TCV) of papillary thyroid carcinoma (PTC), an aggressive form of thyroid cancer, is characterised by 50% of cells with height that is three times greater than the width. Very rarely, some of these cancers can progress to spindle cell squamous carcinoma (SCSC) resulting in cancers with elements of both SCSC and TCV PTC. Here we report a case of SCSC arising from TCV PTC. In addition to this case, we have performed a literature review and compiled all published reports of SCSC arising from TCV PTC, including the nature of treatment and the prognosis for each of the 20 patients recorded. This is intended for use as a guide for clinicians in what the most appropriate treatment options may be for a newly diagnosed patient. Due to the rarity coupled with diagnosis occurring at a very advanced stage of disease progression, performing clinical trials is difficult and therefore drawing conclusions on optimal treatment methods remains a challenge.
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28
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Shenoy VS, Rao RA, Kamath PM, Prasad V, Haseena S. Primary Squamous Cell Carcinoma of Thyroid - A Rare Malignant Goitre. Indian J Surg Oncol 2016; 7:467-469. [PMID: 27872538 PMCID: PMC5097761 DOI: 10.1007/s13193-016-0530-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 05/31/2016] [Indexed: 10/21/2022] Open
Abstract
Primary squamous cell carcinoma of thyroid is a very rare malignant disease because thyroid gland lacks squamous cells. The disease is almost fatal. Only around 60 cases have been reported in literature. Its incidence is less than 1 % of all thyroid malignancies. The overall survival rate is less than 1 year after the diagnosis. Here we report a rare case of a 70 year old lady who presented with sudden increase in the size of swelling associated with pain and obstructive symptoms in long standing thyroid swelling. Considering patient's age and inoperable nature of disease we treated the patient with concurrent chemoradiation.
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Affiliation(s)
- Vijendra S. Shenoy
- Department of ENT and Head & Neck Surgery, Kasturba Medical College, Mangalore, Manipal University, Manipal, India
- Department of Otolaryngology, Kasturba Medical College Hospital, Manipal University, Attavar, Mangalore, Karnataka 575 001 India
| | - Raghavendra A. Rao
- Department of ENT and Head & Neck Surgery, Kasturba Medical College, Mangalore, Manipal University, Manipal, India
| | - Panduranga M. Kamath
- Department of ENT and Head & Neck Surgery, Kasturba Medical College, Mangalore, Manipal University, Manipal, India
| | - Vishnu Prasad
- Department of ENT and Head & Neck Surgery, Kasturba Medical College, Mangalore, Manipal University, Manipal, India
| | - S. Haseena
- Department of ENT and Head & Neck Surgery, Kasturba Medical College, Mangalore, Manipal University, Manipal, India
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Rupani A, Hughes OR, Watkinson J, Nutting CM, Thway K. Metastatic Papillary Thyroid Carcinoma With Adjacent BRAF (V600E)-Mutated Squamous Cell Carcinoma. Int J Surg Pathol 2016; 25:243-245. [PMID: 27829211 DOI: 10.1177/1066896916674811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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30
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Genetic alterations in primary squamous cell carcinoma of the thyroid. Pathology 2016; 48:523-5. [DOI: 10.1016/j.pathol.2016.04.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 03/29/2016] [Accepted: 04/04/2016] [Indexed: 12/28/2022]
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Tavares C, Melo M, Cameselle-Teijeiro JM, Soares P, Sobrinho-Simões M. ENDOCRINE TUMOURS: Genetic predictors of thyroid cancer outcome. Eur J Endocrinol 2016; 174:R117-26. [PMID: 26510840 DOI: 10.1530/eje-15-0605] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 10/28/2015] [Indexed: 12/20/2022]
Abstract
Genetic predictors of outcome are reviewed in the context of a disease--cancer--that can be (too) simplistically described as a 'successful, invasive clone of our own tissues'. Context has many faces that determine a thyroid cancer patient's outcome beyond the influence of genetic markers. There is also plenty of evidence on the prognostic meaning of the interplay between genetics and context/microenvironment factors (encapsulation, degree of invasion, staging, etc.). This review addresses only genetic alterations detected by molecular methods in surgically resected specimens, thus ruling out immunohistochemistry and (F)ISH, despite their crucial relevance as topographically oriented methods. For the sake of the discussion, well-differentiated carcinomas were divided into two main morphologic types: papillary carcinoma (classic and most variants) displaying BRAFV600E mutations and RET/papillary thyroid carcinoma rearrangements and the group of follicular patterned carcinomas that encompasses follicular carcinoma and the encapsulated form of follicular variant of papillary carcinoma, displaying RAS mutations and PAX8/PPARγ rearrangement. TERT promoter mutations have been recently described (and associated with distant metastases and reduced survival) in papillary and follicular carcinomas, as well as in poorly differentiated and undifferentiated carcinoma. TP53 mutations, previously thought to be restricted to less differentiated carcinomas, were also detected in papillary and follicular carcinoma and found to carry a guarded prognosis. Besides their putative importance for targeted therapies, the prognostic meaning of such mutations is discussed per se and in the setting of concurrent BRAF mutation.
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Affiliation(s)
- Catarina Tavares
- Instituto de Investigacão e Inovacão em SaúdeUniversidade do Porto, 4200-135 Porto, PortugalCancer BiologyInstitute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Rua Dr Roberto Frias, s/n, 4200-465 Porto, PortugalMedical FacultyUniversity of Porto, Al. Prof. Hernâni Monteiro, P-4200 Porto, PortugalEndocrinologyDiabetes and Metabolism Department, Centro Hospitalar e Universitário de Coimbra, Praceta Mota Pinto, 3000-075 Coimbra, PortugalMedical FacultyUniversity of Coimbra, Azinhaga de Santa Comba, 3000-548 Coimbra, PortugalDepartment of PathologyMedical Faculty, Servicio Gallego de Salud-SERGAS, Clinical University Hospital, University of Santiago de Compostela, 15705 Santiago de Compostela, SpainDepartment of Pathology and OncologyMedical Faculty of Porto University, Porto, PortugalDepartment of PathologyHospital de S. João, Al. Prof. Hernâni Monteiro, P-4200 Porto, Portugal Instituto de Investigacão e Inovacão em SaúdeUniversidade do Porto, 4200-135 Porto, PortugalCancer BiologyInstitute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Rua Dr Roberto Frias, s/n, 4200-465 Porto, PortugalMedical FacultyUniversity of Porto, Al. Prof. Hernâni Monteiro, P-4200 Porto, PortugalEndocrinologyDiabetes and Metabolism Department, Centro Hospitalar e Universitário de Coimbra, Praceta Mota Pinto, 3000-075 Coimbra, PortugalMedical FacultyUniversity of Coimbra, Azinhaga de Santa Comba, 3000-548 Coimbra, PortugalDepartment of PathologyMedical Faculty, Servicio Gallego de Salud-SERGAS, Clinical University Hospital, University of Santiago de Compostela, 15705 Santiago de Compostela, SpainDepartment of Pathology and OncologyMedical Faculty of Porto University, Porto, PortugalDepartment of PathologyHospital de S. João, Al. Prof. Hernâni Monteiro, P-4200 Porto, Portugal Instituto de Investigacão e Inovacão em SaúdeUniversidade do Porto, 4200-135 Porto, PortugalCancer BiologyInstitute of Molecular Pathology and
| | - Miguel Melo
- Instituto de Investigacão e Inovacão em SaúdeUniversidade do Porto, 4200-135 Porto, PortugalCancer BiologyInstitute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Rua Dr Roberto Frias, s/n, 4200-465 Porto, PortugalMedical FacultyUniversity of Porto, Al. Prof. Hernâni Monteiro, P-4200 Porto, PortugalEndocrinologyDiabetes and Metabolism Department, Centro Hospitalar e Universitário de Coimbra, Praceta Mota Pinto, 3000-075 Coimbra, PortugalMedical FacultyUniversity of Coimbra, Azinhaga de Santa Comba, 3000-548 Coimbra, PortugalDepartment of PathologyMedical Faculty, Servicio Gallego de Salud-SERGAS, Clinical University Hospital, University of Santiago de Compostela, 15705 Santiago de Compostela, SpainDepartment of Pathology and OncologyMedical Faculty of Porto University, Porto, PortugalDepartment of PathologyHospital de S. João, Al. Prof. Hernâni Monteiro, P-4200 Porto, Portugal Instituto de Investigacão e Inovacão em SaúdeUniversidade do Porto, 4200-135 Porto, PortugalCancer BiologyInstitute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Rua Dr Roberto Frias, s/n, 4200-465 Porto, PortugalMedical FacultyUniversity of Porto, Al. Prof. Hernâni Monteiro, P-4200 Porto, PortugalEndocrinologyDiabetes and Metabolism Department, Centro Hospitalar e Universitário de Coimbra, Praceta Mota Pinto, 3000-075 Coimbra, PortugalMedical FacultyUniversity of Coimbra, Azinhaga de Santa Comba, 3000-548 Coimbra, PortugalDepartment of PathologyMedical Faculty, Servicio Gallego de Salud-SERGAS, Clinical University Hospital, University of Santiago de Compostela, 15705 Santiago de Compostela, SpainDepartment of Pathology and OncologyMedical Faculty of Porto University, Porto, PortugalDepartment of PathologyHospital de S. João, Al. Prof. Hernâni Monteiro, P-4200 Porto, Portugal Instituto de Investigacão e Inovacão em SaúdeUniversidade do Porto, 4200-135 Porto, PortugalCancer BiologyInstitute of Molecular Pathology and
| | - José Manuel Cameselle-Teijeiro
- Instituto de Investigacão e Inovacão em SaúdeUniversidade do Porto, 4200-135 Porto, PortugalCancer BiologyInstitute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Rua Dr Roberto Frias, s/n, 4200-465 Porto, PortugalMedical FacultyUniversity of Porto, Al. Prof. Hernâni Monteiro, P-4200 Porto, PortugalEndocrinologyDiabetes and Metabolism Department, Centro Hospitalar e Universitário de Coimbra, Praceta Mota Pinto, 3000-075 Coimbra, PortugalMedical FacultyUniversity of Coimbra, Azinhaga de Santa Comba, 3000-548 Coimbra, PortugalDepartment of PathologyMedical Faculty, Servicio Gallego de Salud-SERGAS, Clinical University Hospital, University of Santiago de Compostela, 15705 Santiago de Compostela, SpainDepartment of Pathology and OncologyMedical Faculty of Porto University, Porto, PortugalDepartment of PathologyHospital de S. João, Al. Prof. Hernâni Monteiro, P-4200 Porto, Portugal
| | - Paula Soares
- Instituto de Investigacão e Inovacão em SaúdeUniversidade do Porto, 4200-135 Porto, PortugalCancer BiologyInstitute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Rua Dr Roberto Frias, s/n, 4200-465 Porto, PortugalMedical FacultyUniversity of Porto, Al. Prof. Hernâni Monteiro, P-4200 Porto, PortugalEndocrinologyDiabetes and Metabolism Department, Centro Hospitalar e Universitário de Coimbra, Praceta Mota Pinto, 3000-075 Coimbra, PortugalMedical FacultyUniversity of Coimbra, Azinhaga de Santa Comba, 3000-548 Coimbra, PortugalDepartment of PathologyMedical Faculty, Servicio Gallego de Salud-SERGAS, Clinical University Hospital, University of Santiago de Compostela, 15705 Santiago de Compostela, SpainDepartment of Pathology and OncologyMedical Faculty of Porto University, Porto, PortugalDepartment of PathologyHospital de S. João, Al. Prof. Hernâni Monteiro, P-4200 Porto, Portugal Instituto de Investigacão e Inovacão em SaúdeUniversidade do Porto, 4200-135 Porto, PortugalCancer BiologyInstitute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Rua Dr Roberto Frias, s/n, 4200-465 Porto, PortugalMedical FacultyUniversity of Porto, Al. Prof. Hernâni Monteiro, P-4200 Porto, PortugalEndocrinologyDiabetes and Metabolism Department, Centro Hospitalar e Universitário de Coimbra, Praceta Mota Pinto, 3000-075 Coimbra, PortugalMedical FacultyUniversity of Coimbra, Azinhaga de Santa Comba, 3000-548 Coimbra, PortugalDepartment of PathologyMedical Faculty, Servicio Gallego de Salud-SERGAS, Clinical University Hospital, University of Santiago de Compostela, 15705 Santiago de Compostela, SpainDepartment of Pathology and OncologyMedical Faculty of Porto University, Porto, PortugalDepartment of PathologyHospital de S. João, Al. Prof. Hernâni Monteiro, P-4200 Porto, Portugal Instituto de Investigacão e Inovacão em SaúdeUniversidade do Porto, 4200-135 Porto, PortugalCancer BiologyInstitute of Molecular Pathology and
| | - Manuel Sobrinho-Simões
- Instituto de Investigacão e Inovacão em SaúdeUniversidade do Porto, 4200-135 Porto, PortugalCancer BiologyInstitute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Rua Dr Roberto Frias, s/n, 4200-465 Porto, PortugalMedical FacultyUniversity of Porto, Al. Prof. Hernâni Monteiro, P-4200 Porto, PortugalEndocrinologyDiabetes and Metabolism Department, Centro Hospitalar e Universitário de Coimbra, Praceta Mota Pinto, 3000-075 Coimbra, PortugalMedical FacultyUniversity of Coimbra, Azinhaga de Santa Comba, 3000-548 Coimbra, PortugalDepartment of PathologyMedical Faculty, Servicio Gallego de Salud-SERGAS, Clinical University Hospital, University of Santiago de Compostela, 15705 Santiago de Compostela, SpainDepartment of Pathology and OncologyMedical Faculty of Porto University, Porto, PortugalDepartment of PathologyHospital de S. João, Al. Prof. Hernâni Monteiro, P-4200 Porto, Portugal Instituto de Investigacão e Inovacão em SaúdeUniversidade do Porto, 4200-135 Porto, PortugalCancer BiologyInstitute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Rua Dr Roberto Frias, s/n, 4200-465 Porto, PortugalMedical FacultyUniversity of Porto, Al. Prof. Hernâni Monteiro, P-4200 Porto, PortugalEndocrinologyDiabetes and Metabolism Department, Centro Hospitalar e Universitário de Coimbra, Praceta Mota Pinto, 3000-075 Coimbra, PortugalMedical FacultyUniversity of Coimbra, Azinhaga de Santa Comba, 3000-548 Coimbra, PortugalDepartment of PathologyMedical Faculty, Servicio Gallego de Salud-SERGAS, Clinical University Hospital, University of Santiago de Compostela, 15705 Santiago de Compostela, SpainDepartment of Pathology and OncologyMedical Faculty of Porto University, Porto, PortugalDepartment of PathologyHospital de S. João, Al. Prof. Hernâni Monteiro, P-4200 Porto, Portugal Instituto de Investigacão e Inovacão em SaúdeUniversidade do Porto, 4200-135 Porto, PortugalCancer BiologyInstitute of Molecular Pathology and
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Primary Squamous Cell Carcinoma of Trachea Arising 4 Years After Radioiodine Treatment of Papillary Carcinoma of Thyroid. Clin Nucl Med 2016; 41:e259-60. [PMID: 26828143 DOI: 10.1097/rlu.0000000000001140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Primary squamous cell carcinoma (SCC) of the trachea is rare. Here, we presented a rare case of primary SCC of the trachea arising 4 years after radioiodine (RAI) treatment of papillary carcinoma of the thyroid. In this case, concomitant uptake of I-RAI and F-FDG was demonstrated in the thyroidal mass with tracheal invasion, which mimicked mixed well-differentiated and dedifferentiated thyroid carcinoma. The diagnosis of SCC of the trachea was made only after tracheal biopsy. This case illustrates that FDG-avid thyroid bed lesion, in the presence of thyroid carcinoma, may not necessarily be related to the thyroid pathology.
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Acosta AM, Pins MR. Papillary thyroid carcinoma with extensive squamous dedifferentiation metastatic to the lung: BRAF mutational analysis as a useful tool to rule out tumor to tumor metastasis. Virchows Arch 2015; 468:239-42. [DOI: 10.1007/s00428-015-1875-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Accepted: 10/21/2015] [Indexed: 11/30/2022]
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Cho JK, Woo SH, Park J, Kim MJ, Jeong HS. Primary squamous cell carcinomas in the thyroid gland: an individual participant data meta-analysis. Cancer Med 2014; 3:1396-403. [PMID: 24995699 PMCID: PMC4302690 DOI: 10.1002/cam4.287] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Revised: 05/19/2014] [Accepted: 05/21/2014] [Indexed: 12/20/2022] Open
Abstract
Primary squamous cell carcinomas arising from the thyroid gland (SCCTh) is extremely rare diseases, which have never been fully studied. Thus, we performed a systematic review and individual participant data meta-analysis of published SCCTh cases, to understand the clinical characteristics and to identify the prognostic factors of primary SCCTh. A literature search was conducted within Medline, EMBASE, Cochrane library databases and KoreaMed using the following Medical Subject Headings (MeSH) keywords: “primary,” “squamous,” “carcinoma,” “cancer,” and “thyroid.” Eighty-four patients' individual data from 39 articles and five patients' data in our institute were selected for analysis (N = 89). The mean age at diagnosis was 63.0 years (range, 24–90) and female preponderance (M:F = 1:2) was noted. The commonest complaint was the anterior neck mass, followed by dyspnea or dysphagia, and extension to the adjacent structure was found in 72%. The median survival was 9.0 months (95% CI, 6.0–23.0) and 3-year survival rate (3YSR) was 37.6% by Kaplan–Meier method, but only 20.1% by a shared frailty model for adjusting heterogeneity. Complete resection (R0) of tumors was the only significant prognostic factor in multivariable analysis, and the benefit of adjuvant treatment was not proved. The prognosis of patients with SCCTh is very poor (20% in 3YSR), but complete resection of disease is correlated with improved survival. To achieve complete surgical eradication of tumors, early detection and accurate diagnosis should be emphasized.
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Affiliation(s)
- Jae Keun Cho
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Lim YZ, South AP. Tumour-stroma crosstalk in the development of squamous cell carcinoma. Int J Biochem Cell Biol 2014; 53:450-8. [PMID: 24955488 DOI: 10.1016/j.biocel.2014.06.012] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 06/13/2014] [Accepted: 06/14/2014] [Indexed: 12/23/2022]
Abstract
Squamous cell carcinoma (SCC) represents one of the most frequently diagnosed tumours and contributes significant mortality worldwide. Recent deep sequencing of cancer genomes has identified common mutations in SCC arising across different tissues highlighting perturbation of squamous differentiation as a key event. At the same time significant data have been accumulating to show that common tumour-stroma interactions capable of driving disease progression are also evident when comparing SCC arising in different tissues. We and others have shown altered matrix composition surrounding SCC can promote tumour development. This review focuses on some of the emerging data with particular emphasis on SCC of head and neck and skin with discussion on the potential tumour suppressive properties of a normal microenvironment. Such data indicate that regardless of the extent and type of somatic mutation it is in fact the tumour context that defines metastatic progression.
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Affiliation(s)
- Yok Zuan Lim
- Division of Cancer Research, Medical Research Institute, Ninewells Hospital and Medical School, University of Dundee, UK; Institute of Medical Biology, A*Star, Singapore
| | - Andrew P South
- Division of Cancer Research, Medical Research Institute, Ninewells Hospital and Medical School, University of Dundee, UK; Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, United States.
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Jang JY, Kwon KW, Kim SW, Youn I. Primary squamous cell carcinoma of thyroid gland with local recurrence: ultrasonographic and computed tomographic findings. Ultrasonography 2014; 33:143-8. [PMID: 24936508 PMCID: PMC4058984 DOI: 10.14366/usg.13022] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Accepted: 01/03/2014] [Indexed: 11/24/2022] Open
Abstract
Primary squamous cell carcinoma of the thyroid gland (PSCCT) is a rare malignancy that presents with advanced disease and poor prognosis. It is difficult to diagnose PSCCT in its early stage because of its rarity and lack of typical imaging findings. We experienced an elderly woman with PSCCT confirmed by surgery. Although preoperative fine-needle aspiration revealed no malignancy, surgical resection was performed because the ultrasonogram showed diffuse microcalcifications, which suggested malignancy, and clinically, the mass grew rapidly to compress the trachea. Local tumor recurrence was noted at 3 months after surgery. Surgical resection or repeat biopsy should be considered if a cytologically benign thyroid mass shows imaging or clinical features of malignancy.
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Affiliation(s)
- Ja Yoon Jang
- Departments of Radiology, Bundang Jesaeng General Hospital, Seongnam, Korea
| | - Kye Won Kwon
- Departments of Pathology, Bundang Jesaeng General Hospital, Seongnam, Korea
| | - Sang Wook Kim
- Departments of Surgery, Bundang Jesaeng General Hospital, Seongnam, Korea
| | - Inyoung Youn
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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Ghoshal S, Bhattacharyya T, Sood A, Tyagi R. Palliative radiation in primary squamous cell carcinoma of thyroid: a rare case report. Indian J Palliat Care 2013; 19:192-4. [PMID: 24347911 PMCID: PMC3853399 DOI: 10.4103/0973-1075.121541] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Primary squamous cell carcinoma of the thyroid is an extremely rare neoplasm with aggressive behavior. Until date, only around 60 cases have been reported in the literature. Primary treatment of the patient is radical surgery. With optimum treatment survival is not more than 6 months in this aggressive malignancy. However in our patient surgery it was not possible because of unresectability of the mass due to encroachment of major vessels. Hence, we have delivered radiotherapy alone, with which effective palliation could be achieved and patient is leading a good quality-of-life for last 1 year.
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Affiliation(s)
- Sushmita Ghoshal
- Departments of Radiation Oncology, Nuclear Medicine, and Histopathology, PGIMER, Chandigarh, India
| | - Tapesh Bhattacharyya
- Departments of Radiation Oncology, Nuclear Medicine, and Histopathology, PGIMER, Chandigarh, India
| | - Ashwani Sood
- Departments of Radiation Oncology, Nuclear Medicine, and Histopathology, PGIMER, Chandigarh, India
| | - Ruchita Tyagi
- Departments of Radiation Oncology, Nuclear Medicine, and Histopathology, PGIMER, Chandigarh, India
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The Ki-67/MIB-1 index level and recurrence of papillary thyroid carcinoma. Med Hypotheses 2013; 80:311-4. [DOI: 10.1016/j.mehy.2012.12.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Revised: 12/10/2012] [Accepted: 12/13/2012] [Indexed: 11/18/2022]
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Evans WDG. De-differentiation of papillary thyroid carcinoma into squamous cell carcinoma. A case of coexistence within an excised neck lesion. BMJ Case Rep 2012; 2012:bcr-2012-007707. [PMID: 23220838 DOI: 10.1136/bcr-2012-007707] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
An 80-year-old man with papillary thyroid carcinoma of the neck underwent surgery and radioiodide therapy. He presented 11 years later with a lesion adjudged from fine needle aspiration to be a squamous cell carcinoma (SCC). Histological analysis of the excised mass revealed a lymph node overwhelmed with papillary thyroid carcinoma and moderately differentiated SCC thought to have transformed from papillary cells. A very small number of similar transformations specifically involving the 'tall cell variant' of papillary carcinoma transforming to spindle cell carcinoma have been reported previously. This case report demonstrates clear images of this rare occurrence and briefly considers factors leading to de-differentiation. The clinician should consider possible transformation from papillary thyroid cancer in cases of SCC of the head and neck as this variation may be more aggressive.
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40
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Evans WDG. De-differentiation of papillary thyroid carcinoma into squamous cell carcinoma. A case of coexistence within an excised neck lesion. BMJ Case Rep 2012. [PMID: 23220838 DOI: 10.1136/bcr-2012-007707.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
An 80-year-old man with papillary thyroid carcinoma of the neck underwent surgery and radioiodide therapy. He presented 11 years later with a lesion adjudged from fine needle aspiration to be a squamous cell carcinoma (SCC). Histological analysis of the excised mass revealed a lymph node overwhelmed with papillary thyroid carcinoma and moderately differentiated SCC thought to have transformed from papillary cells. A very small number of similar transformations specifically involving the 'tall cell variant' of papillary carcinoma transforming to spindle cell carcinoma have been reported previously. This case report demonstrates clear images of this rare occurrence and briefly considers factors leading to de-differentiation. The clinician should consider possible transformation from papillary thyroid cancer in cases of SCC of the head and neck as this variation may be more aggressive.
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Shrestha M, Sridhara SK, Leo LJ, Coppit GL, Ehrhardt NM. Primary squamous cell carcinoma of the thyroid gland: a case report and review. Head Neck 2012; 35:E299-303. [PMID: 23002023 DOI: 10.1002/hed.23152] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2012] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Primary squamous cell carcinoma (SCC) of the thyroid gland is a rare malignancy that presents with advanced disease and poor prognosis. METHODS A 75-year-old woman with a history of Hashimoto thyroiditis presented with 6 months of dysphagia and stridor. Imaging revealed a thyroid mass invading the larynx. Primary SCC of the thyroid was diagnosed by histopathologic and immunohistochemical evaluation. Total thyroidectomy, total laryngectomy, bilateral modified neck dissection, and adjuvant radiotherapy (RT) were performed. Radiologic follow-up at 21 months demonstrated no disease and total length of survival was 31 months. RESULTS Despite an aggressive T4aN0M0 tumor, survival in this case was more than double the median survival rate previously reported. Concomitant Hashimoto thyroiditis is rare and histopathologic and immunohistochemical evaluation is imperative for an accurate diagnosis. CONCLUSION The case and literature reported here support that a thorough diagnostic workup of primary SCC of the thyroid with aggressive locoregional surgery and adjuvant RT may improve the length of survival.
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Affiliation(s)
- Merica Shrestha
- Department of Medicine, Endocrinology, Diabetes and Metabolism Service, Dwight D. Eisenhower Army Medical Center, 300 Hospital Road, Fort Gordon, Georgia
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Shaik S, Nucera C, Inuzuka H, Gao D, Garnaas M, Frechette G, Harris L, Wan L, Fukushima H, Husain A, Nose V, Fadda G, Sadow PM, Goessling W, North T, Lawler J, Wei W. SCF(β-TRCP) suppresses angiogenesis and thyroid cancer cell migration by promoting ubiquitination and destruction of VEGF receptor 2. ACTA ACUST UNITED AC 2012; 209:1289-307. [PMID: 22711876 PMCID: PMC3405505 DOI: 10.1084/jem.20112446] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The E3 ubiquitin ligase β-TRCP, acting in concert with casein kinase I, drives ubiquitination and degradation of VEGFR2, and renders human papillary thyroid cancer cells resistant to the VEGFR2 inhibitor sorafenib. The incidence of human papillary thyroid cancer (PTC) is increasing and an aggressive subtype of this disease is resistant to treatment with vascular endothelial growth factor receptor 2 (VEGFR2) inhibitor. VEGFR2 promotes angiogenesis by triggering endothelial cell proliferation and migration. However, the molecular mechanisms governing VEGFR2 stability in vivo remain unknown. Additionally, whether VEGFR2 influences PTC cell migration is not clear. We show that the ubiquitin E3 ligase SCFβ-TRCP promotes ubiquitination and destruction of VEGFR2 in a casein kinase I (CKI)–dependent manner. β-TRCP knockdown or CKI inhibition causes accumulation of VEGFR2, resulting in increased activity of signaling pathways downstream of VEGFR2. β-TRCP–depleted endothelial cells exhibit enhanced migration and angiogenesis in vitro. Furthermore, β-TRCP knockdown increased angiogenesis and vessel branching in zebrafish. Importantly, we found an inverse correlation between β-TRCP protein levels and angiogenesis in PTC. We also show that β-TRCP inhibits cell migration and decreases sensitivity to the VEGFR2 inhibitor sorafenib in poorly differentiated PTC cells. These results provide a new biomarker that may aid a rational use of tyrosine kinase inhibitors to treat refractory PTC.
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Affiliation(s)
- Shavali Shaik
- Division of Cancer Biology and Angiogenesis, Department of Pathology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA
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Mercante G, Marchesi A, Covello R, Dainese L, Spriano G. Mixed squamous cell carcinoma and follicular carcinoma of the thyroid gland. Auris Nasus Larynx 2012; 39:310-3. [DOI: 10.1016/j.anl.2011.07.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Revised: 07/27/2011] [Accepted: 07/28/2011] [Indexed: 10/17/2022]
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Ko YS, Hwang TS, Han HS, Lim SD, Kim WS, Oh SY. Primary pure squamous cell carcinoma of the thyroid: report and histogenic consideration of a case involving a BRAF mutation. Pathol Int 2012; 62:43-8. [PMID: 22192803 DOI: 10.1111/j.1440-1827.2011.02745.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Primary squamous cell carcinoma of the thyroid (SCC-T) is extremely rare. Its clinical presentation is similar to that of anaplastic carcinoma. Metastasis or extension from the head and neck area should be ruled out, as patients with SCC-T have a poorer prognosis than patients who have a thyroid extension from an adjacent tumor. An 87-year-old man presented with a longstanding painless mass in the right thyroid and had experienced 2 months of pain upon swallowing. A right lobectomy was performed with resection of thyroid cartilage, cricoid cartilage, a portion of the first to third tracheal ring and the right neck lymph node. A histological examination revealed pure SCC. The tumor cells showed diffuse immunoreactivity to CK5/6, CK19 and p63. Immunoreactivity to EMA and p53 was focally positive. TTF-1, galectin 3 and thyroglobulin immunoreactivity was restricted to the non-neoplastic thyroid tissue. Both tumor cells and non-neoplastic follicular cells were negative for CD5. The MIB-1 index was 36%. DNA extracted from the tumor identified a BRAF V600E mutation in exon 15 and a BRAF G468A mutation in exon 11, whereas DNA from non-tumorous cells did not contain a mutation. These molecular findings may suggest a direct transformation from papillary carcinoma to SCC-T.
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Affiliation(s)
- Young Sin Ko
- Department of Pathology, Konkuk University Medical Center, Gwangjin-gu, Seoul, Korea
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Tunio MA, Al Asiri M, Fagih M, Akasha R. Primary squamous cell carcinoma of thyroid: a case report and review of literature. HEAD & NECK ONCOLOGY 2012; 4:8. [PMID: 22452749 PMCID: PMC3331844 DOI: 10.1186/1758-3284-4-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Accepted: 03/27/2012] [Indexed: 11/10/2022]
Abstract
BACKGROUND Thyroid gland lacks squamous epithelium (except in some rare situations like embroyonic remnants or in inflammatory processes); for that reason the primary squamous cell carcinoma (SCC) of thyroid is extremely rare entity, seen only in less than 1% of all thyroid malignancies and is considered almost fatal. So, far, only few case reports have been published in literature. CASE PRESENTATION Herein we present a 54 years old Saudi female with 3 months history of progressive neck swelling and hoarse voice, who was referred to us by her primary care physician as suspected case of anaplastic carcinoma of thyroid for radical external beam radiation therapy (EBRT). Fine Needle aspiration cytology (FNAC) revealed squamous cell carcinoma. Computed tomography (CT) neck showed 10 × 10 cm mass in left lobe of thyroid invading trachea and skin. Extensive staging work up ruled out the possibility of any primary site of SCC other than thyroid gland. Tumor was found unresectable and was referred to radiation oncology. She received palliative EBRT 30 Gy in 10 fractions. After completion of EBRT, there was progression of disease and patient died 3 months after completion of EBRT by airway compromise. CONCLUSION Primary SCC of thyroid is rare and aggressive entity. FNAC is reliable and effective tool for immediate diagnosis. Surgery is a curative option, but it is not always possible as most of cases present as locally advanced with adjacent organs involvement. EBRT alone was found ineffective. Aggressive combined modality (debulking surgery, radiation and chemotherapy) shall be considered for such cases.
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Affiliation(s)
- Mutahir A Tunio
- Department of Radiation Oncology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, PO 59046, Saudi Arabia
| | - Mushabbab Al Asiri
- Department of Radiation Oncology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, PO 59046, Saudi Arabia
| | - Mosa Fagih
- Department of Cytogenetics, King Fahad Medical City, Riyadh, PO 59046, Saudi Arabia
| | - Rashad Akasha
- Resident Radiation Oncology, Department of Radiation Oncology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, PO 59046, Saudi Arabia
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Ito Y, Higashiyama T, Hirokawa M, Fukushima M, Kihara M, Takamura Y, Kobayashi K, Miya A, Miyauchi A. Clinical trial of weekly paclitaxel chemotherapy for papillary thyroid carcinoma with squamous cell carcinoma component. Endocr J 2012; 59:839-44. [PMID: 22673602 DOI: 10.1507/endocrj.ej12-0174] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Papillary thyroid carcinoma (PC) can occasionally include a squamous cell carcinoma (SCC) component. In this study, we evaluated the effect of weekly paclitaxel chemotherapy in 3 patients with PC including an SCC component. None of these patients had lesions of anaplastic carcinoma on pathological examination. Weekly paclitaxel chemotherapy was performed as an induction chemotherapy for 2 patients. All 3 patients underwent locally curative surgery and weekly paclitaxel chemotherapy after surgery as an adjuvant therapy. The response to the chemotherapy was evaluated based on the RECIST guideline (version 1.1). Two patients had partial responses (PRs) and the remaining 1 had stable disease (SD). The response rate was 67% and the clinical benefit rate (PR+SD) was 100%. One patient died of the growth of lung metastases that had been detected before surgery 22 months after the diagnosis. The remaining 2 are still alive, 14 and 22 months after the diagnosis, respectively. Taken together, weekly paclitaxel may be one of the effective adjuvant therapies for PC with an SCC component.
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Affiliation(s)
- Yasuhiro Ito
- Department of Surgery, Kuma Hospital, Kobe 650-0011, Japan.
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Biological behavior of papillary carcinoma of the thyroid including squamous cell carcinoma components and prognosis of patients who underwent locally curative surgery. J Thyroid Res 2011; 2012:230283. [PMID: 21941683 PMCID: PMC3175380 DOI: 10.1155/2012/230283] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2011] [Accepted: 07/18/2011] [Indexed: 12/18/2022] Open
Abstract
Thyroid carcinoma showing squamous differentiation throughout the entire lesion is diagnosed as squamous cell carcinoma of the thyroid (SCCT) in the WHO classification. This entity is a rare disease and shows a dire prognosis; however, squamous differentiation is more frequently detected in only a portion of papillary thyroid carcinoma. In this paper, we present our experience of 10 patients (8 primary lesions and 2 with recurrence in the lymph nodes) with papillary thyroid carcinoma having an SCC component (PTC-SCC). Only 3 of 8 primary lesions (38%) and none of the 2 recurrent nodes were preoperatively diagnosed as or suspected of having SCC components. All 10 patients underwent locally curative surgery. To date, 3 patients have died of carcinoma, and 2 had distant metastasis at diagnosis or had an undifferentiated carcinoma component. The other 7 are currently alive 5 to 43 months after diagnosis. Systemic adjuvant therapy after the detection of recurrence was effective for 2 patients. It is possible that some PTC-SCC patients without distant metastasis who undergo locally curative surgery can survive for a prolonged period and adjuvant therapies can be effective for local and distant recurrences.
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Warman M, Lipschitz N, Ikher S, Halperin D. Collision tumor of the thyroid gland: primary squamous cell and papillary thyroid carcinoma. ISRN OTOLARYNGOLOGY 2011; 2011:582374. [PMID: 23724255 PMCID: PMC3658539 DOI: 10.5402/2011/582374] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2011] [Accepted: 04/12/2011] [Indexed: 12/13/2022]
Abstract
Introduction. Collision tumor of the thyroid gland is defined when independent and histologically distinct tumors coexist within the gland. The presence of both papillary and squamous cell carcinoma in the thyroid gland is unusual. Suggested etiologies include embryonic remanents of squamous epithelium, chronic inflammation, or thyroid malignancies promoting squamous metaplasia. Case Presentation. An elderly patient presented with a rapid enlargement of a long-standing right thyroid nodule. The tumor was locally invasive and unresectable. Pathology revealed the diagnosis of papillary and squamous cell carcinoma of the thyroid gland. Possible primary sites for squamous cell carcinoma in upper aerodigestive tract were excluded. The patient outcome was fatal although palliative chemoradiotherapy. Discussion. Collision tumor of papillary and squamous cell carcinoma of the thyroid gland is a rare entity that may imply bad prognosis, as to the presence of the squamous portion. The best treatment includes resection of the tumor; unfortunately it is not possible in most cases.
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Affiliation(s)
- Meir Warman
- Department of Otolaryngology, Head and Neck Surgery, Kaplan Medical Center, P.O.B. 1, Rehovot 76100, Israel ; Hebrew University Hadassah Medical School, Ein Kerem, P.O.B. 1200, Jerusalem 91120, Israel
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Gopal PP, Montone KT, Baloch Z, Tuluc M, LiVolsi V. The variable presentations of anaplastic spindle cell squamous carcinoma associated with tall cell variant of papillary thyroid carcinoma. Thyroid 2011; 21:493-9. [PMID: 21309723 DOI: 10.1089/thy.2010.0338] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND In 1976, Hawk and Hazard described the tall cell variant (TCV) of papillary thyroid carcinoma (PTC). While the lesions they described had cytologic features of papillary carcinoma, they showed more aggressive behavior with a greater propensity for extrathyroid extension and lymphovascular invasion than classic PTC. In 1991, Bronner and LiVolsi described a series of patients with TCV that progressed to spindle cell squamous carcinoma (SCSC), a unique form of anaplastic thyroid carcinoma. This study describes the variable clinical and pathologic presentations in 31 patients with anaplastic SCSC arising in association with TCV. METHODS The surgical pathology archives as well as the personal consultation files of one of the authors (V.A.L.) were reviewed to retrieve cases of SCSC arising in association with TCV. The available clinical as well as pathologic information on all patients was reviewed. RESULTS A total of 31 patients with SCSC arising in association with TCV were retrieved from our files. The average age at primary presentation was 67 (range 32-92) with a female-to-male ratio of 2:1. Three clinical scenarios for SCSC associated with TCV were identified. These were type I, consisting of TCV with SCSC at the time of presentation (18 patients); type II, consisting of SCSC arising as a recurrence in patients with a known history of TCV (5 patients); and type III, consisting of SCSC presenting as a primary laryngeal squamous cell carcinoma in a patient with or without a known history of TCV (8 patients). The type III cases were of most concern since they often were confused with primary laryngeal squamous cell carcinoma and most often were diagnosed after laryngectomy. CONCLUSIONS SCSC of the thyroid is almost exclusively associated with TCV and can have variable clinical presentations. SCSC is most commonly seen associated with a primary diagnosis of TCV. SCSC may be seen, however, in patients with recurrent PTC and most importantly may present in a fashion similar to primary laryngeal SCSC. Therefore, caution should be exercised in evaluating laryngeal squamous lesions in patients with known history of TCV and without known risks factors for head and neck carcinogenesis.
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Affiliation(s)
- Pallavi P Gopal
- Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA.
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Squamous cell carcinoma of the thyroid gland: primary or secondary disease? The Journal of Laryngology & Otology 2010; 125:3-9. [PMID: 20950510 DOI: 10.1017/s0022215110002070] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To review the aetiopathogenesis, clinical characteristics, immunohistochemical profile, prognosis and treatment options for primary thyroid squamous cell carcinoma, and to compare it with squamous cell carcinoma metastatic to the thyroid, thus providing the reader with a framework for differentiating primary and secondary disease. METHOD Review of English language literature from the past 25 years. SEARCH STRATEGY A search of the Medline, Embase and Cochrane databases (April 1984 to April 2009) was undertaken to enable a comprehensive review. RESULTS After applying strict criteria for the diagnosis of primary thyroid squamous cell carcinoma, 28 articles were identified reporting 84 cases. When reviewing secondary thyroid squamous cell carcinoma, we only analysed cases of squamous cell carcinoma metastatic to the thyroid gland, and found 28 articles reporting 78 cases. CONCLUSION It is possible to differentiate between primary and secondary thyroid squamous cell carcinoma, on the basis of combined evidence from clinical examination and endoscopic, pathological and radiological evaluation. Such differentiation is important, as the prognosis for primary squamous cell carcinoma is uniformly poor irrespective of treatment, and the most suitable option may be supportive therapy. Treatment for secondary squamous cell carcinoma of the thyroid varies with the site and extent of spread of the primary tumour.
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