1
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Zhang X, Zhu G, Tang B, Huang H, Chen C, Zheng S, Pu Y, Xu Y, Wang G, Huang D, Liu Y, Zhang X. A characterization and prognosis prediction model for primary squamous cell carcinoma of the thyroid. Gland Surg 2021; 10:1325-1338. [PMID: 33968684 DOI: 10.21037/gs-20-847] [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: 01/21/2023]
Abstract
Background Primary squamous cell carcinoma of the thyroid (PSCCTh) is a sporadic malignancy arising from the thyroid gland. The factors that affect treatment and survival in patients with PSCCTh remain unclear. Our study aims to characterize PSCCTh and establish a prognosis prediction model for patients with PSCCTh. Methods Clinical data and follow-up information for 277 patients from 1973 to 2016 were collected from the Surveillance, Epidemiology, and End Results Program (SEER) 18-registry database (RRID:SCR_003293). Univariate and multivariate Cox proportional hazards analyses and nomogram modeling of potential prognostic factors were conducted. Results Among the collected patient cases, 57% were female and 43% were male. The median survival of all cases was 6 months; by gender, median survival was 5 and 8 months in the female and male groups, respectively. Univariate and multivariate Cox proportional hazards analyses revealed that age, extent of disease (EOD), T stage, N stage, and treatment were independent prognostic indicators for overall survival (OS) and disease-specific survival (DSS) in patients with PSCCTh. In addition, it was confirmed that the established nomogram model had good consistency and discrimination for PSCCTh prognosis as measured by the concordance index (C-index), area under the receiver operating characteristic (ROC) curve (AUC), and calibration curves. Conclusions Our study indicates that age, EOD, T stage, N stage, and treatment may correlate with OS and DSS in patients with PSCCTh. Importantly, our nomogram prediction model, constructed using parameters including age, T stage, N stage, and treatment, may assist physicians in evaluating patients' prognoses and providing precise therapy for PSCCTh.
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Affiliation(s)
- Xingyu Zhang
- Department of Otolaryngology-Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, China
| | - Gangcai Zhu
- Department of Otolaryngology-Head and Neck Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Bin Tang
- Department of Otolaryngology-Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, China
| | - Huimei Huang
- Department of Otolaryngology-Head and Neck Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Changhan Chen
- Department of Otolaryngology-Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, China
| | - Siyuan Zheng
- Department of Otolaryngology-Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, China
| | - Yuting Pu
- Department of Otolaryngology-Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, China
| | - Yimin Xu
- Department of Otolaryngology-Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, China
| | - Gang Wang
- Department of Otolaryngology-Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, China
| | - Donghai Huang
- Department of Otolaryngology-Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, China.,Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, China.,Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Changsha, China.,National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Changsha, China
| | - Yong Liu
- Department of Otolaryngology-Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, China.,Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, China.,Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Changsha, China.,National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Changsha, China
| | - Xin Zhang
- Department of Otolaryngology-Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, China.,Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, China.,Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Changsha, China.,National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Changsha, China
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2
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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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3
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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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4
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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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6
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CHENG PU, XIANG YINGYING, CHEN ENDONG, ZOU ZHANGYONG, ZHANG XIAOHUA. Papillary thyroid microcarcinoma with synchronous asymptomatic advanced esophageal squamous cell carcinoma: A case report and review of the literature. Oncol Lett 2015; 9:731-734. [PMID: 25624899 PMCID: PMC4301557 DOI: 10.3892/ol.2014.2748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2014] [Accepted: 11/12/2014] [Indexed: 11/06/2022] Open
Abstract
Papillary thyroid microcarcinoma (PTMC) is a subset of papillary thyroid carcinoma, with tumors measuring ≤1.0 cm in maximum diameter. Esophageal squamous cell carcinoma (ESCC) is the most common histopathological subtype of the various esophageal malignancies. The present study reports a rare synchronous presentation of PTMC and asymptomatic ESCC manifesting as lateral cervical lymph node enlargement. The patient, a 70-year-old male who presented to the Department of Surgical Oncology, The First Affiliated Hospital of Wenzhou Medical University (Wenzhou, China)with no significant symptoms, was identified to have bilateral thyroid nodules by ultrasonography and enlarged lymph nodes on the left side of the neck by palpation. A diagnosis of PTMC with lateral cervical lymph node metastasis was established and the patient underwent right lobectomy, partial left lobectomy and lymph node biopsy. Pathological analysis of the intraoperative frozen biopsy indicated bilateral PTMC and metastatic lymph node SCC from a different primary location. Furthermore, histological examination of the biopsied lymph nodes revealed bilateral PTMC and poorly-differentiated SCC, which was verified as ESCC by gastroscopy and postoperative histopathological examination. A review of the present literature indicated that no similar case has been reported thus far. The patient succumbed three months after attending Ruijin Hospital, Shanghai Jiao Tong University School of Medicine (Shanghai, China) for additional treatment.
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Affiliation(s)
| | | | - ENDONG CHEN
- Department of Surgical Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
| | - ZHANGYONG ZOU
- Department of Surgical Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
| | - XIAOHUA ZHANG
- Department of Surgical Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
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7
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Primary squamous cell carcinoma of the thyroid diagnosed as anaplastic carcinoma: failure in fine-needle aspiration cytology? Case Rep Pathol 2014; 2014:301780. [PMID: 25295208 PMCID: PMC4175754 DOI: 10.1155/2014/301780] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Accepted: 08/20/2014] [Indexed: 12/16/2022] Open
Abstract
A case of primary squamous-cell carcinoma (SCC) of the thyroid which had been initially diagnosed as an anaplastic carcinoma (ATC) is described: female, 73 years old, with a fast-growing cervical nodule on the left side and hoarseness for 3 months. Ultrasonography showed a 4.5 cm solid nodule. FNA was compatible with poorly differentiated carcinoma with immunoreactivity for AE1/AE3, EMA. Thyroidectomy was performed. Histopathological examination showed a nonencapsulated tumor. Immunohistochemistry disclosed positivity for AE1/AE3, p53,p63, and Ki67. The diagnosis was ATC. A second opinion reported tumor consisting of squamous cells, with intense inflammatory infiltrate both in tumor and in the adjacent thyroid, with final diagnosis of SCC, associated with Hashimoto thyroiditis. No other primary focus of SCC was found. Patient has shown a 48-month survival period. Clinically, primary SCCs of the thyroid and ATCs are similar. The distinction is often difficult particularly when based on the cytological analysis of FNA material.
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8
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Manrique Franco K, Cedeño Díaz Oderay M, Aragón Valera C, Sánchez-Vilar Burdiel O, Rovira Loscos A. Papillary thyroid carcinoma associated to squamous cell carcinoma. ACTA ACUST UNITED AC 2013; 61:226-8. [PMID: 24332292 DOI: 10.1016/j.endonu.2013.10.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2013] [Revised: 09/05/2013] [Accepted: 10/14/2013] [Indexed: 11/26/2022]
Affiliation(s)
- Katty Manrique Franco
- Servicio de Endocrinología y Nutrición, Hospital Universitario Fundación Jiménez Díaz, Madrid, España.
| | | | - Carmen Aragón Valera
- Servicio de Endocrinología y Nutrición, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
| | | | - Adela Rovira Loscos
- Servicio de Endocrinología y Nutrición, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
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9
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Smallridge RC, Ain KB, Asa SL, Bible KC, Brierley JD, Burman KD, Kebebew E, Lee NY, Nikiforov YE, Rosenthal MS, Shah MH, Shaha AR, Tuttle RM. American Thyroid Association guidelines for management of patients with anaplastic thyroid cancer. Thyroid 2012; 22:1104-39. [PMID: 23130564 DOI: 10.1089/thy.2012.0302] [Citation(s) in RCA: 477] [Impact Index Per Article: 39.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Anaplastic thyroid cancer (ATC) is a rare but highly lethal form of thyroid cancer. Rapid evaluation and establishment of treatment goals are imperative for optimum patient management and require a multidisciplinary team approach. Here we present guidelines for the management of ATC. The development of these guidelines was supported by the American Thyroid Association (ATA), which requested the authors, members the ATA Taskforce for ATC, to independently develop guidelines for ATC. METHODS Relevant literature was reviewed, including serial PubMed searches supplemented with additional articles. The quality and strength of recommendations were adapted from the Clinical Guidelines Committee of the American College of Physicians, which in turn was developed by the Grading of Recommendations Assessment, Development and Evaluation workshop. RESULTS The guidelines include the diagnosis, initial evaluation, establishment of treatment goals, approaches to locoregional disease (surgery, radiotherapy, 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 65 recommendations. CONCLUSIONS These are the first comprehensive guidelines for ATC and provide recommendations for management of this extremely aggressive malignancy. Patients with stage IVA/IVB resectable disease have the best prognosis, particularly if a multimodal approach (surgery, radiation, systemic therapy) is used, and some stage IVB unresectable patients may respond to aggressive therapy. Patients with stage IVC disease should be considered for a clinical trial or hospice/palliative care, depending upon their preference.
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10
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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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11
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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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12
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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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13
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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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14
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De Vos FYFL, Sewnaik A, de Wilt JHW, Smid EJ, den Bakker MA, van Meerten E. Combined therapy for thyroid squamous cell carcinoma. Head Neck 2010; 34:131-4. [PMID: 20652981 DOI: 10.1002/hed.21484] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2010] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND.: Squamous carcinoma of the thyroid is a rare aggressive disease, resulting in poor prognosis. METHODS AND RESULTS.: We combined cisplatin with paclitaxel on a weekly basis as induction therapy, achieving a high cumulative dose, in a patient with squamous cell tumor of the thyroid with arterial encasement. After surgery, pathologic examination confirmed a complete resection of the primary tumor with clear margins, revealing a successful induction treatment with chemotherapy. CONCLUSIONS.: Our patient now has a recurrence-free survival of >20 months, longer than the mean survival described in the literature.
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Affiliation(s)
- Filip Yves F L De Vos
- Department of Internal Oncology, Erasmus University Medical Center, Rotterdam, The Netherlands.
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15
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Cameselle-Teijeiro J. Warning about the poor prognosis of squamous cell carcinoma of the thyroid. Int J Surg Pathol 2010; 18:341. [PMID: 20308043 DOI: 10.1177/1066896910363807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- José Cameselle-Teijeiro
- Department of Anatomic Pathology, Hospital Clínico Universitario, University of Santiago de Compostela, Galicia, Santiago de Compostela, Spain.
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Kondo T, Matsuyoshi A, Matsuyoshi H, Goto R, Ono K, Honda Y, Iyama KI, Tsuruzoe K, Miyamura N, Araki E. A case of primary thyroid squamous cell cancer: transformation from benign tumour associated with chronic thyroiditis? BMJ Case Rep 2009; 2009:bcr10.2008.1137. [PMID: 21686450 DOI: 10.1136/bcr.10.2008.1137] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Primary squamous cell cancer of the thyroid gland (SCT) is a rare malignant tumour and is associated with a high mortality. A female patient who suffered from primary SCT is described in this report. The cancer was identified with acute painful swelling of the thyroid gland, when the patient was under periodical observation for her chronic thyroiditis at our outpatient's clinic. In spite of the highly malignant potential of the cancer as indicated by histological examinations, including p53 and MIB-1 index analyses, the patient has been successfully treated so far with surgery and radiation therapy, surviving for more than 34 months with no sign of recurrence or metastasis. Early diagnosis and prompt treatment might have been essential for the successful management of this patient. Further observations and investigations are necessary to clarify the mechanisms of the long survival and to find a better treatment for the disease.
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Affiliation(s)
- Tatsuya Kondo
- Kumamoto University, Department of Metabolic Medicine, 1-1-1 Honjo, Kumamoto, Kumamoto, 860-8556, Japan
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Solitary intrathyroidal metastasis of renal clear cell carcinoma in a toxic substernal multinodular goiter. Thyroid Res 2008; 1:6. [PMID: 19014412 PMCID: PMC2596782 DOI: 10.1186/1756-6614-1-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2008] [Accepted: 10/24/2008] [Indexed: 01/21/2023] Open
Abstract
Introduction Thyroid gland is a rare site of clinically detectable tumor metastasis. Case report A 71-year-old woman was referred to our department for an evaluation of toxic multinodular substernal goiter. She had a history of renal clear cell carcinoma of the left kidney, which had been resected 2 years previously. US confirmed the multinodular goiter. Total thyroidectomy with neuromonitoring was performed on March 2008. A histological examination revealed a solitary metastasis of a clear cell renal cancer in a diffuse multinodular goiter. No distant metastases are detected. Conclusion Although uncommon, it is important for the endocrine surgeon and endocrine oncologist to be able to recognize and differentiate intrathyroid metastases from more primary common thyroid neoplasms. The diagnosis can be suspected if the patient has a thyroid tumor and a past history of extrathyroid cancer. These tumors, on the whole, tend to behave more aggressively and, in most cases, the use of multimodality therapy is recommended.
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