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Iqbal A, Lee KT, Yasinzai AQK, Li Z, Wali A, Tareen B, Khan I, Khan M, Ullah A. Prognostic Factors and Survival Outcomes in Squamous Cell Carcinoma of the Thyroid: A Surveillance, Epidemiology, and End Results (SEER) Database Analysis. Cureus 2024; 16:e63326. [PMID: 39077275 PMCID: PMC11283922 DOI: 10.7759/cureus.63326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2024] [Indexed: 07/31/2024] Open
Abstract
Introduction Squamous cell carcinoma of the thyroid (SCCT) is a rare, aggressive thyroid cancer distinguished by the emergence of squamous cells due to chronic inflammation or metaplasia. It poses diagnostic and therapeutic challenges, often identified at an advanced stage with a poor prognosis. The rarity of SCCT underscores the necessity for advanced research on effective treatments and diagnostic strategies. The current data utilized the Surveillance, Epidemiology, and End Results (SEER) database to determine the characteristics and outcomes of patients with primary SCCT. Methods De-identified data from patients with primary SCCT from 2000 to 2020 were collected using the SEER database. Demographic data, including age, sex, race, income, and housing, and clinical data including tumor size, tumor stage, nodal status, metastases, treatment modality, survival, and the patient's status, were extracted. Exclusion criteria were patients with unknown outcomes and missing death certificates. A detailed comparison of the two patient cohorts and univariate and multivariate Cox proportional hazard regression survival analyses were conducted. Results Among the 159 primary SCCT patients, the median age was 71 ± 21 years, with 83 females (52.2%) and 76 males (47.8%). The median overall follow-up was 6.0 years (4.41-7.59). The majority were White (108, 67.9%), followed by Hispanic (19, 11.9%). The five-year overall survival (OS) of the study group was 17.6% (95% CI = 14.5-20.7). The five-year disease-specific survival (DSS) was 37.6% (95% CI = 32.7-42.5). There was no significant difference based on surgery, chemotherapy, or radiation (p = 0.134). Age, tumor stage, nodal status, and distant metastases were negative prognostic factors. Sex, race, income, and housing were not predictive of survival. Conclusion The current study on SCCT highlights a low five-year OS rate of 17.6% and a DSS rate of 37.6%, with no significant difference in survival based on surgery, chemotherapy, or radiation. The negative prognostic factors included age, tumor stage, nodal status, and distant metastases, whereas sex, race, income, and housing did not significantly predict survival outcomes. These findings underscore the critical need for early detection and the development of more effective treatment strategies to manage SCCT.
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Affiliation(s)
| | - Kue T Lee
- Otolaryngology, Augusta University Medical College of Georgia, Augusta, USA
| | | | - Ziyang Li
- Medicine, Texas Tech University Health Sciences Center, Lubbock, USA
| | - Agha Wali
- Internal Medicine, Bolan Medical College, Quetta, PAK
| | - Bisma Tareen
- Internal Medicine, Bolan Medical College, Quetta, PAK
| | - Israr Khan
- Medicine, Insight Hospital and Medical Center, Chicago, USA
| | - Marjan Khan
- Internal Medicine, Marshfield Medical Center, Marshfield, USA
| | - Asad Ullah
- Pathology, Texas Tech University Health Sciences Center, Lubbock, USA
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Ding W, Gao X, Ran X. Progress in diagnosing and treating thyroid squamous cell carcinoma under the 5th edition of WHO classification. Front Endocrinol (Lausanne) 2024; 14:1273472. [PMID: 38303977 PMCID: PMC10833225 DOI: 10.3389/fendo.2023.1273472] [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: 08/06/2023] [Accepted: 12/20/2023] [Indexed: 02/03/2024] Open
Abstract
Squamous cell carcinoma of the thyroid (SCCT) is a rare thyroid gland malignancy, with only a few hundred cases reported in the literature, mostly as case reports or small sample studies. In the previous WHO classification, squamous cell carcinoma of the thyroid was defined as a carcinoma composed entirely of squamous cells without differentiated carcinoma components. It was once included in the WHO tumor classification separately. However, the 2022 WHO classification of squamous cell carcinoma of the thyroid was reclassified as a morphologic subtype of anaplastic thyroid carcinoma (ATC). The squamous cell carcinoma pattern is similar to the other histologic types of ATC, but the phenotype associated has a poorer prognosis. The typical clinical manifestation of this condition is a cervical mass, accompanied by indications and symptoms of compression on adjacent structures such as the esophagus and trachea in advanced stages. Secondary squamous cell carcinoma of the thyroid may occur due to the spread of squamous carcinoma of the larynx or esophagus or distant metastases from other sites. Diagnosis of squamous cell carcinoma of the thyroid includes neck Ultrasound (US), Computed Tomography (CT) or Magnetic Resonance Imaging (MRI), puncture tissue biopsy, and full endoscopy to identify metastatic lesions from the nasopharynx, oropharynx, hypopharynx, larynx, esophagus, or bronchi and to help with the initial staging of the tumor. Current treatment modalities include surgery, radiotherapy, chemotherapy, or a combination. Because of the poor prognosis of patients with this disease, the short survival period, usually less than one year, and the difficulty of preoperative diagnosis, this article reviews the epidemiological features, origin, clinical features, pathological features, and differential diagnosis to improve the diagnosis and treatment of this disease by clinicians.
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Affiliation(s)
| | - Xiaofan Gao
- Department of Thyroid Surgery, The Second Hospital of Jilin University, Changchun, China
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3
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Primary squamous cell carcinoma of thyroid gland: 11 case reports and a population-based study. World J Surg Oncol 2022; 20:352. [PMID: 36329478 PMCID: PMC9632099 DOI: 10.1186/s12957-022-02814-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 10/16/2022] [Indexed: 11/05/2022] Open
Abstract
Background Primary squamous cell carcinoma of thyroid gland (PSCCT) is a highly aggressive malignant tumor associated with a poor prognosis. Due to the rare case, there is a knowledge gap on the features of PSCCT. There is limited understanding of the treatment and molecular biology of this tumor. More genomic work and relevant perspective work need to be done. Methods We retrospectively reviewed the medical information of patients with PSCCT diagnosed from December 2009 to December 2020 at The First Affiliated Hospital of Guangxi Medical University. In addition, we conducted an electronic search of the paper in CNKI, Wanfang, VIP, PubMed, Embase, Web of Science, and ProQuest databases by recently updated articles. Survival analysis was conducted using the Kaplan–Meier method. Results There were only 11 patients met the study’s inclusion criteria in our institution. The patients ranged in age from 25 to 68 years old and female preponderance (M:F = 1:1.7). The median survival time was 6 months, and 1-year survival rate was 33.3%. Fifty-three patients’ individual data from 45 articles were selected for analysis. The median age at diagnosis was 63 years and female preponderance (M:F = 1:2.5). The commonest complaint was the anterior neck mass (77.3%), followed by hoarseness (32.1%). The median survival time was 9 months, and the overall 1-, 2-, and 5-year survival rate was 39.8%, 33.7%, and 26.9%, respectively. The log-rank method shows that age, tumor size, lymph node status, M stage, surgical range, and tracheal status were the relevant factors affecting the prognosis. In contrast, gender, treatment modality, and resection margin were not prognostic factors. On multivariable analysis, age and M stage were associated with overall survival. Conclusion The median overall survival was 6–9 months of PSCCT. Age and M stage are predictors of PSSCT. Supplementary Information The online version contains supplementary material available at 10.1186/s12957-022-02814-9.
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Bible KC, Kebebew E, Brierley J, Brito JP, Cabanillas ME, Clark TJ, Di Cristofano A, Foote R, Giordano T, Kasperbauer J, Newbold K, Nikiforov YE, Randolph G, Rosenthal MS, Sawka AM, Shah M, Shaha A, Smallridge R, Wong-Clark CK. 2021 American Thyroid Association Guidelines for Management of Patients with Anaplastic Thyroid Cancer. Thyroid 2021; 31:337-386. [PMID: 33728999 PMCID: PMC8349723 DOI: 10.1089/thy.2020.0944] [Citation(s) in RCA: 283] [Impact Index Per Article: 94.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background: Anaplastic thyroid cancer (ATC) is a rare but highly lethal form of thyroid cancer. Since the guidelines for the management of ATC by the American Thyroid Association were first published in 2012, significant clinical and scientific advances have occurred in the field. The aim of these guidelines is to inform clinicians, patients, and researchers on published evidence relating to the diagnosis and management of ATC. Methods: The specific clinical questions and topics addressed in these guidelines were based on prior versions of the guidelines, stakeholder input, and input of the Task Force members (authors of the guideline). Relevant literature was reviewed, including serial PubMed searches supplemented with additional articles. The American College of Physicians Guideline Grading System was used for critical appraisal of evidence and grading strength of recommendations. Results: The guidelines include the diagnosis, initial evaluation, establishment of treatment goals, approaches to locoregional disease (surgery, radiotherapy, targeted/systemic therapy, supportive care during active therapy), approaches to advanced/metastatic disease, palliative care options, surveillance and long-term monitoring, and ethical issues, including end of life. The guidelines include 31 recommendations and 16 good practice statements. Conclusions: We have developed evidence-based recommendations to inform clinical decision-making in the management of ATC. While all care must be individualized, such recommendations provide, in our opinion, optimal care paradigms for patients with ATC.
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Affiliation(s)
- Keith C. Bible
- Division of Medical Oncology, Mayo Clinic, Rochester, Minnesota, USA
| | - Electron Kebebew
- Stanford University, School of Medicine, Stanford, California, USA
| | - James Brierley
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Juan P. Brito
- Division of Diabetes, Endocrinology, Metabolism, and Nutrition, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Maria E. Cabanillas
- Department of Endocrine Neoplasia & Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | | | - Antonio Di Cristofano
- Department of Developmental and Molecular Biology, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Robert Foote
- Department of Radiation Oncology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA
| | - Thomas Giordano
- Department of Pathology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Jan Kasperbauer
- Department of Otolaryngology, Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Kate Newbold
- The Royal Marsden NHS Foundation Trust, Fulham Road, London, United Kingdom
| | - Yuri E. Nikiforov
- Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Gregory Randolph
- Division of Thyroid and Parathyroid Endocrine Surgery, Massachusetts Eye and Ear, Boston, Massachusetts, USA
| | - M. Sara Rosenthal
- Program for Bioethics and Markey Cancer Center Oncology Ethics Program, Departments Internal Medicine, Pediatrics and Behavioral Science, University of Kentucky, Lexington, Kentucky, USA
| | - Anna M. Sawka
- Division of Endocrinology, Department of Medicine, University Health Network and University of Toronto, Toronto, Canada
| | - Manisha Shah
- The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Ashok Shaha
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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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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Prognostic Characteristics of Primary Squamous Cell Carcinoma of the Thyroid: A National Cancer Database Analysis. World J Surg 2020; 44:348-355. [PMID: 31399796 DOI: 10.1007/s00268-019-05098-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Primary squamous cell carcinoma of the thyroid (ThySCC) is a rare cancer, primarily described only in case reports. We aimed to characterize the prognosis of ThySCC and compare its oncologic behavior to other thyroid malignancies. METHODS The National Cancer Database was queried to identify patients with ThySCC, papillary, tall cell variant, poorly differentiated (PDTC), and anaplastic (ATC) subtypes of thyroid cancer treated from 2004 to 2015. Demographics, tumor characteristics, and treatments were compared by tumor type and assessed to identify independent predictors of overall survival (OS). RESULTS Of 123,684 patients included, 314 had ThySCC. ThySCC patients had a 5-year OS of 17.7%, more closely resembling ATC (8.3%) than PDTC or PTC. ThySCC and ATC patients had similar demographics, except ThySCC patients who were younger (68.0 vs. 70.2 years, p < 0.01). ThySCC tumors were smaller (mean 53.5 ± 45.7 vs. 69.5 ± 75.2 mm) with less frequent extrathyroidal extension (ETE) (64.0% vs. 73.8%), lymphovascular invasion (8.3% vs. 12.3%), and positive margins (22.0% vs. 28.3%) compared to ATCs (p < 0.05). ETE [HR 3.1 (95% CI 1.5-6.4), p < 0.05] and lymph node metastases [HR 2.2 (95% CI 1.2-4.0) p < 0.05] were independently associated with worse OS for ThySCC patients. Both ThySCC and ATC patients had similar surgical success rates, with R1 resection possible in 37.3% versus 35.0% of patients, respectively (p < 0.05). However, in contrast to ATC patients, adjuvant therapy was not associated with improved OS for ThySCC patients after complete resection. CONCLUSIONS ThySCC has a poor prognosis, similar to ATC, but with fewer aggressive features and no apparent survival benefit with adjuvant therapy after complete macroscopic surgical resection.
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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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8
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Madariaga ML, Gaissert HA. Secondary tracheal tumors: a systematic review. Ann Cardiothorac Surg 2018; 7:183-196. [PMID: 29707496 PMCID: PMC5900082 DOI: 10.21037/acs.2018.02.01] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 12/21/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND Secondary tracheal tumors arise from mural invasion by primary tumors in adjacent organs, metastatic lymph nodes or blood-born metastasis from distant sites. This systematic review aims to assess the presentation, management options, and clinical outcomes of these uncommon non-tracheal malignancies. METHODS Electronic searches of the MEDLINE database were performed to identify case series and individual case reports of tracheal invasion by primary non-tracheal tumors or metastatic disease. All English-language studies with available abstracts or articles containing primary data were included. RESULTS From 1978 to 2017, a total of 160 case reports or case series identified 2,242 patients with invasion of the trachea by tumors of adjacent organs (n=1,853) or by metastatic lymph nodes or hematogenous spread (n=389). Common primary sites of origin were thyroid, esophagus, and lung, and the most common presentation was metachronous (range of interval: 0 to 564 months) with dyspnea, neck mass, voice change and/or hemoptysis. A majority of patients in case reports (77.9%) and case series (66.0%) underwent resection and the most common reported operation was segmental tracheal resection. Fewer patients underwent bronchoscopic intervention (21.7%) and radiation was used in 32.2% of patients. Complications after bronchoscopic treatment included bleeding, granulation tissue, and retained secretions, while anastomotic leak, unplanned tracheostomy, and new recurrent laryngeal nerve paralysis were observed after surgical resection. The rate of 30-day mortality was low (0.01-1.80%). Median survival was higher in patients with thyroid malignancy and in patients who underwent surgical management. Follow-up time ranged from 0.03 to 183 months. CONCLUSIONS Patients with tracheal invasion by metastatic or primary non-tracheal malignancies should be assessed for symptoms, tumor grade, tumor recurrence and concurrent metastases to decide on optimal surgical, bronchoscopic or noninterventional therapy. Clinical experience suggests that palliative endoscopic intervention for tracheal obstruction by metastasis-bearing lymph nodes is underreported.
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Affiliation(s)
- Maria Lucia Madariaga
- Division of Thoracic Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Henning A Gaissert
- Division of Thoracic Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
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9
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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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Quero G, Consales M, Severino R, Vaiano P, Boniello A, Sandomenico A, Ruvo M, Borriello A, Diodato L, Zuppolini S, Giordano M, Nettore IC, Mazzarella C, Colao A, Macchia PE, Santorelli F, Cutolo A, Cusano A. Long period fiber grating nano-optrode for cancer biomarker detection. Biosens Bioelectron 2016; 80:590-600. [DOI: 10.1016/j.bios.2016.02.021] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 01/27/2016] [Accepted: 02/08/2016] [Indexed: 10/22/2022]
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Dong S, Song XS, Chen G, Liu J. Mixed primary squamous cell carcinoma, follicular carcinoma, and micropapillary carcinoma of the thyroid gland: A case report. Auris Nasus Larynx 2015; 43:455-9. [PMID: 26589365 DOI: 10.1016/j.anl.2015.10.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 10/11/2015] [Accepted: 10/20/2015] [Indexed: 10/22/2022]
Abstract
Primary squamous cell carcinoma of the thyroid gland is rare, and mixed squamous cell and follicular carcinoma is even rarer still, with only a few cases reported in the literature. The simultaneous presentation of three primary cancers of the thyroid has not been reported previously. Here we report a case of primary squamous cell carcinoma of the thyroid, follicular thyroid carcinoma, and micropapillary thyroid carcinoma. A 62-year-old female patient presented with complaints of pain and a 2-month history of progressively increased swelling in the anterior region of the neck. Fine-needle-aspiration cytology of both lobes indicated the possibility of the presence of a follicular neoplasm. Total thyroidectomy with left-sided modified radical neck dissection was performed. Postoperative pathological examination confirmed the diagnosis of thyroid follicular carcinoma with squamous cell carcinoma and micropapillary carcinoma of the thyroid. Thyroid-stimulating hormone suppressive therapy with l-thyroxine was administered. Radioiodine and radiotherapy also were recommended, but the patient did not complete treatment as scheduled. The patient remained alive more than 9 months after operation. The present case report provides an example of the coexistence of multiple distinct malignancies in the thyroid.
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Affiliation(s)
- Su Dong
- Department of Anesthesia, First Hospital of Jilin University, Changchun 130021, China
| | - Xue-Song Song
- Department of Anesthesia, First Hospital of Jilin University, Changchun 130021, China
| | - Guang Chen
- Department of Thyroid Surgery, First Hospital of Jilin University, Changchun 130021, China
| | - Jia Liu
- Department of Thyroid Surgery, First Hospital of Jilin University, Changchun 130021, China.
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12
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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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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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