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Yuan Z, Luo Y. Ultrasonographic findings of tracheal adenoid cystic carcinoma with thyroid invasion and mimicking thyroid tumors: a case report. Gland Surg 2024; 13:571-577. [PMID: 38720680 PMCID: PMC11074661 DOI: 10.21037/gs-23-485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 03/14/2024] [Indexed: 05/12/2024]
Abstract
Background Tracheal adenoid cystic carcinoma (TACC) is a rare, low-grade malignant tumor. The primary TACC usually metastasizes to the lung and bone, rarely involving the thyroid. Although some previous reports have described the imaging features of TACC with thyroid invasion, the multimodal ultrasound findings of TACC with thyroid invasion and mimicking thyroid tumors have not been reported before. Case Description A 69-year-old woman who had been experiencing hoarseness for 2 years and a thyroid nodule for 2 months was presented to our clinic. Conventional ultrasound showed a hypoechoic nodule about 33×25×50 mm in the left lobe and isthmus of the thyroid, adjacent to the trachea and extending to the right lobe. Contrast-enhanced ultrasound (CEUS) showed that the nodule was unevenly enhanced, with iso-enhancement in the periphery and hypo-enhancement in most of the central area. Shear wave elastography showed that the maximum Young's modulus of nodules was 237.5 kPa, the minimum was 0.1 kPa, and the average was 60.5 kPa. Triiodothyronine, thyroxine, thyroid stimulating hormone and calcitonin were within the normal range. The patient underwent radical surgery with an uneventful postoperative recovery. Combined with the intraoperative findings and pathological examination, the diagnosis of TACC with thyroid invasion was made. Conclusions This rare case shows that TACC invading the thyroid may be manifested as a thyroid tumor on ultrasound. Preoperative pathological examination and comprehensive imaging examination are of great significance for the clinical management of patients. We also reviewed the literature on the imaging findings and clinical performance for TACC with thyroid invasion.
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Affiliation(s)
- Zhiqiang Yuan
- Department of Medical Ultrasound, West China Hospital, Sichuan University, Chengdu, China
| | - Yan Luo
- Department of Medical Ultrasound, West China Hospital, Sichuan University, Chengdu, China
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Duan X, Hu T, Cai H, Lin L, Zeng L, Wang H, Cao L, Li X. Radiotherapy for primary thyroid adenoid cystic carcinoma. Open Life Sci 2023; 18:20220547. [PMID: 36910470 PMCID: PMC9993328 DOI: 10.1515/biol-2022-0547] [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: 08/24/2022] [Revised: 12/02/2022] [Accepted: 12/14/2022] [Indexed: 03/09/2023] Open
Abstract
Primary thyroid adenoid cystic carcinoma (PTACC) is an extremely rare type of mucin-secreting adenocarcinoma. Currently, it is difficult to diagnose, and it lacks standard treatment protocols. We report the case of a 53-year-old female patient with PTACC who underwent additional intensity-modulated radiotherapy 1 month after surgical treatment with an uneventful course. No invasion or distant metastasis was detected at the 7-month follow-up after radiotherapy, and the prognosis was favorable. In this case, herein, we have summarized the diagnostic features of the disease and proposed that postoperative adjuvant radiotherapy can significantly improve the patient's prognosis. Finally, we further confirmed the important role of radiotherapy in PTACC by reviewing relevant literature, which may provide clinicians with valuable treatment experience.
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Affiliation(s)
- Xiaoyu Duan
- The First Clinical Medical College, Gansu University of Chinese Medicine, Number 35 Ding Xing East Road, Lanzhou, 730000 China.,Department of Radiotherapy, Gansu Provincial Hospital, Number 204 Dong Gang West Road, Lanzhou, 730000 China
| | - Tingting Hu
- Department of Radiotherapy, Gansu Provincial Hospital, Number 204 Dong Gang West Road, Lanzhou, 730000 China
| | - Hongyi Cai
- Department of Radiotherapy, Gansu Provincial Hospital, Number 204 Dong Gang West Road, Lanzhou, 730000 China
| | - Lili Lin
- The First Clinical Medical College, Gansu University of Chinese Medicine, Number 35 Ding Xing East Road, Lanzhou, 730000 China.,Department of Radiotherapy, Gansu Provincial Hospital, Number 204 Dong Gang West Road, Lanzhou, 730000 China
| | - Lu Zeng
- The First Clinical Medical College, Gansu University of Chinese Medicine, Number 35 Ding Xing East Road, Lanzhou, 730000 China.,Department of Radiotherapy, Gansu Provincial Hospital, Number 204 Dong Gang West Road, Lanzhou, 730000 China
| | - Huixia Wang
- The First Clinical Medical College, Gansu University of Chinese Medicine, Number 35 Ding Xing East Road, Lanzhou, 730000 China.,Department of Radiotherapy, Gansu Provincial Hospital, Number 204 Dong Gang West Road, Lanzhou, 730000 China
| | - Lei Cao
- The First Clinical Medical College, Gansu University of Chinese Medicine, Number 35 Ding Xing East Road, Lanzhou, 730000 China.,Department of Radiotherapy, Gansu Provincial Hospital, Number 204 Dong Gang West Road, Lanzhou, 730000 China
| | - Xuxia Li
- The First Clinical Medical College, Gansu University of Chinese Medicine, Number 35 Ding Xing East Road, Lanzhou, 730000 China.,Department of Radiotherapy, Gansu Provincial Hospital, Number 204 Dong Gang West Road, Lanzhou, 730000 China
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Beute JE, Seo GT, Saturno M, Xing MH, Mundi N, Dowling EM, Matloob A, Chen H, Khorsandi AS, Steinberger J, Urken ML. Central compartment neoplasms masquerading as thyroid tumors: Presentation of two unusual cases and review of the literature. OTOLARYNGOLOGY CASE REPORTS 2022. [DOI: 10.1016/j.xocr.2022.100471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Jikuzono T, Suzuki S, Ishibashi O, Kure S, Sakanushi A, Nakamizo M, Kawamoto M, Ohashi R, Yamada T, Sugitani I. Clinical Utility of Fine Needle Aspiration Cytology for Adenoid Cystic Carcinoma of the Trachea with Thyroid Invasion: A Case Report. J NIPPON MED SCH 2021; 89:460-465. [PMID: 33867428 DOI: 10.1272/jnms.jnms.2022_89-207] [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] [Indexed: 11/19/2022]
Abstract
BACKGROUND Adenoid cystic carcinoma of the trachea (ACCT) is a rare cancer; ACCT with thyroid invasion is particularly rare. We first suspected anaplastic thyroid carcinoma (ATC) but diagnosed ACC after performing fine needle aspiration cytology (FNAC). A tracheal origin was confirmed after operation. CASE DESCRIPTION We report the case of a 77-year-old female presenting to our hospital with acute inspiratory dyspnea requiring emergency tracheotomy. Physical examination revealed a right anterior neck swelling with a hard and unmovable mass. Computed tomography (CT) and ultrasonography (US) showed tumor extension to the right thyroid lobe, and between the first and third tracheal rings, which caused severe stenosis of the lumen. Next, we performed FNAC. Clinical findings were highly suspicious for ACCT with thyroid invasion. Thirty-five days after the first visit to our department, the patient underwent total laryngectomy, cervical esophagectomy, and thyroidectomy with bilateral selective neck dissections at another hospital. The tumor was located in the right posterior wall of the trachea, with extension into the right thyroid gland. Pathological examination showed an infiltrative carcinomatous proliferation with tubular and cribriform patterns. The tumor was classified as pT4N1. A definite diagnosis was made after histopathological analyis of the surgical specimen confirmed ACCT. The tumor was found to be positive for FABP7, a putative prognostic marker of ACC, and metastasized to the lungs 3 years after the surgery. CONCLUSIONS ACCT with thyroid invasion is an extremely rare malignant neoplasm. FNAC was useful for differentiating ACCT from other diagnoses and enabled appropriate surgical treatment.
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Affiliation(s)
| | | | - Osamu Ishibashi
- Department of Endocrine Surgery, Nippon Medical School.,Laboratory of Biological Macromolecules, Department of Applied Life Sciences, Graduate School of Life & Environmental Sciences, Osaka Prefecture University
| | - Shoko Kure
- Department of Integrated Diagnostic Pathology, Nippon Medical School.,Department of Diagnostic Pathology, Nippon Medical School Musashi Kosugi Hospital
| | - Atsuko Sakanushi
- Department of Otolaryngology, Head and Neck Surgery, Nippon Medical School
| | | | - Masashi Kawamoto
- Department of Diagnostic Pathology, Teikyo University Mizonokuchi Hospital
| | - Ryuji Ohashi
- Department of Integrated Diagnostic Pathology, Nippon Medical School
| | - Tetsu Yamada
- Department of Endocrine Surgery, Nippon Medical School.,Department of Endocrine Surgery, Kanaji Thyroid Hospital
| | - Iwao Sugitani
- Department of Endocrine Surgery, Nippon Medical School
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Khader J, Al-Mousa A, Al Khatib S, Wadi-Ramahi S. Successful Development of a Competency-Based Residency Training Program in Radiation Oncology: Our 15-Year Experience from Within a Developing Country. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2020; 35:1011-1016. [PMID: 31154636 DOI: 10.1007/s13187-019-01557-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
One of the main challenges of delivering high quality of care to cancer patients in developing countries is the lack of well-trained radiation oncologists. This is a direct cause for the lack of residency programs coupled with lack of resources. This article describes and details establishments of a successful and sustainable radiation-oncology residency program in our country. The program has been in operation for 14 years and has trained and graduated radiation oncologists who are now working in various countries. The curriculum of the 4-year residency program, fashioned according to American College of Radiologists (ACR) recommendations, includes site-specific clinical rotations and didactic lectures in clinical oncology, radiobiology, medical physics, statistics, and epidemiology. It also includes a component of advanced clinical experience in the form of 3-month externship at one of collaborating centers outside the country. Evaluation of the residents is conducted annually via written exams and 360° feedback. Residents also sit for the formal certification exam in radiation oncology from the national Medical Council. The exam consists of 2 written exams and one oral. As a form of benchmarking residents' knowledge, they are required to sit for the ACR examinations held annually and conducted in Amman in tandem. The program has successfully trained and graduated 28 residents, who now work as consultant radiation oncologists locally and abroad. Each resident has gone through a structured training that includes exposure to a Western-style patient-management culture, enhancing the breadth and width of their clinical experience. The residency program, initiated in a developing country, underwent many challenges, yet it overcome all obstacles and resulted in a successful training of competent radiation oncologists serving the region.
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Affiliation(s)
- Jamal Khader
- Radiation Oncology Department, King Hussein Cancer Center, P.O. Box 1269, Al-Jubeiha, Amman, 11941, Jordan.
| | - Abdelatif Al-Mousa
- Radiation Oncology Department, King Hussein Cancer Center, P.O. Box 1269, Al-Jubeiha, Amman, 11941, Jordan
| | - Sondos Al Khatib
- Radiation Oncology Department, King Hussein Cancer Center, P.O. Box 1269, Al-Jubeiha, Amman, 11941, Jordan
| | - Shada Wadi-Ramahi
- Biomedical Physics Department, MBC#03, King Faisal Specialist Hospital and Research Center, PO Box 3354, Riyadh, 11211, Kingdom of Saudi Arabia
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