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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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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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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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Bonetti LR, Lupi M, Trani M, Trani N, Sartori G, Schirosi L, Bettelli S, Zanelli G, Maccio L, Maiorana A. EGFR Polysomy in Squamous Cell Carcinoma of the Thyroid. Report of Two Cases and Review of the Literature. TUMORI JOURNAL 2018; 96:503-7. [DOI: 10.1177/030089161009600323] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims and background Primary squamous cell carcinoma of the thyroid gland (PSCCT) is an uncommon malignancy characterized by a poor prognosis. A radical surgical approach combined with radiotherapy or chemotherapy is the generally accepted treatment for this tumor. The epidermal growth factor receptor (EGFR) is a transmembrane tyrosine kinase receptor modulating the cell proliferation and biological progression of many human epithelial tumors. The EGFR overexpression in PSCCT suggests an additional therapeutic option for the treatment of this tumor. Methods and study design The clinicopathological features and immunohistochemical profiles of two cases of primary squamous cell carcinoma of the thyroid in a 66-year-old and an 83-year-old woman are presented. EGFR status was valued in both cases. Results Overexpression of EGFR protein was detected in 50% and 75% of the tumor cell membranes. EGRF gene polysomy was detected in both tumors. Conclusions Pharmaceuticals targeting EGFR may help to provide the rationale for an additional, novel therapeutic option for this rare tumor, especially when other therapeutic options have been exhausted.
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Affiliation(s)
- Luca Reggiani Bonetti
- Dipartimento Integrato Servizi Diagnostici e di Laboratorio e di Medicina Legale, Sezione di Anatomia Patologica, Università degli Studi di Modena e Reggio Emilia, Italy
| | - Massimo Lupi
- Dipartimento Integrato Servizi Diagnostici e di Laboratorio e di Medicina Legale, Sezione di Anatomia Patologica, Università degli Studi di Modena e Reggio Emilia, Italy
| | - Margherita Trani
- Clinica Otorinolaringoiatrica, Policlinico di Modena, Università degli studi di Modena e Reggio Emilia, Italy
| | - Nicoletta Trani
- Dipartimento Integrato Servizi Diagnostici e di Laboratorio e di Medicina Legale, Sezione di Medicina Legale, Università degli Studi di Modena e Reggio Emilia, Italy
| | - Giuliana Sartori
- Dipartimento Integrato Servizi Diagnostici e di Laboratorio e di Medicina Legale, Sezione di Anatomia Patologica, Università degli Studi di Modena e Reggio Emilia, Italy
| | - Laura Schirosi
- Dipartimento Integrato Servizi Diagnostici e di Laboratorio e di Medicina Legale, Sezione di Anatomia Patologica, Università degli Studi di Modena e Reggio Emilia, Italy
| | - Stefania Bettelli
- Dipartimento Integrato Servizi Diagnostici e di Laboratorio e di Medicina Legale, Sezione di Anatomia Patologica, Università degli Studi di Modena e Reggio Emilia, Italy
| | - Giuliana Zanelli
- Dipartimento Integrato Servizi Diagnostici e di Laboratorio e di Medicina Legale, Sezione di Anatomia Patologica, Università degli Studi di Modena e Reggio Emilia, Italy
| | - Livia Maccio
- Dipartimento Integrato Servizi Diagnostici e di Laboratorio e di Medicina Legale, Sezione di Anatomia Patologica, Università degli Studi di Modena e Reggio Emilia, Italy
| | - Antonio Maiorana
- Dipartimento Integrato Servizi Diagnostici e di Laboratorio e di Medicina Legale, Sezione di Anatomia Patologica, Università degli Studi di Modena e Reggio Emilia, Italy
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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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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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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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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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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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Stempfer R, Kubicek M, Lang IM, Christa N, Gerner C. Quantitative assessment of human serum high-abundance protein depletion. Electrophoresis 2009; 29:4316-23. [PMID: 18956433 DOI: 10.1002/elps.200800211] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The aim of this study is to quantify the effectivity of the depletion of human high-abundance serum and plasma proteins for improved protein identification and disease marker candidate discovery and to assess the risk of concomitant removal of relevant marker proteins. 2-DE and bottom-up shotgun MS combining 2-D capillary chromatography with MS/MS were applied in parallel for the analysis of fractions resulting from the depletion procedure. For many proteins the factors of enrichment by the depletion were obvious allowing their enhanced detection and identification upon high-abundance protein depletion. Nano-liquid chromatography linked MS allowed the efficient identification of several low-abundant proteins that were not identified on the 2-DE gels. Resolving the fractions that were eluted from the matrix upon depletion indicated unspecific binding of disease relevant proteins in plasma samples from acute myocardial infarction patients. The unspecific binding to the depletion matrix of inflammatory markers spiked into the serum was found to depend on the type of capturing agent used. Polyclonal avian antibodies (IgY) displayed the least unspecific binding due to the high immunogenicity of mammalian proteins in avian hosts.
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Affiliation(s)
- Rene Stempfer
- Molecular Diagnostics, Life Sciences, Austrian Research Centers GmbH - ARC, Seibersdorf, Austria
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