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Kamalumpundi V, Meyers E, Torfah M, de Gusmão Correia ML. A patient with a rare co-occurrence of papillary and follicular thyroid carcinomas. Clin Case Rep 2024; 12:e8707. [PMID: 38585590 PMCID: PMC10996043 DOI: 10.1002/ccr3.8707] [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: 12/15/2023] [Revised: 02/07/2024] [Accepted: 02/10/2024] [Indexed: 04/09/2024] Open
Abstract
The occurrence of papillary and follicular thyroid carcinoma as a collision tumor is rare. We report on a case of a collision tumor consisting of papillary and follicular thyroid carcinoma treated successfully with surgery and radioiodine ablation.
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Affiliation(s)
| | - Erin Meyers
- Division of Endocrinology and Metabolism, Department of Internal MedicineUniversity of Iowa Hospitals and ClinicsIowa CityIowaUSA
| | - Maisoon Torfah
- Division of Endocrinology and Metabolism, Department of Internal MedicineUniversity of Iowa Hospitals and ClinicsIowa CityIowaUSA
| | - Marcelo Lima de Gusmão Correia
- Roy J. and Lucille A. Carver College of MedicineUniversity of IowaIowa CityIowaUSA
- Division of Endocrinology and Metabolism, Department of Internal MedicineUniversity of Iowa Hospitals and ClinicsIowa CityIowaUSA
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Wang Y, Yin D, Ren G, Wang Z, Kong F. Mixed medullary‑follicular thyroid carcinoma: A case report and literature review. Oncol Lett 2023; 26:429. [PMID: 37664658 PMCID: PMC10472022 DOI: 10.3892/ol.2023.14015] [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: 03/14/2023] [Accepted: 07/27/2023] [Indexed: 09/05/2023] Open
Abstract
Papillary thyroid cancer (PTC) and medullary thyroid cancer (MTC) originate from follicular and neuroendocrine parafollicular C cells, respectively. PTC and MTC simultaneously exist in tumors containing both MTC and PTC features in a rare condition known as mixed medullary-follicular thyroid carcinoma (MMFTC). In the present study, a 60-year-old female presented with a small mass on the left side of the neck. Ultrasonography indicated a hyperechoic nodule measuring ~11.9×9.7 mm2 in the left lobe of the thyroid gland. The preoperative calcitonin serum value was elevated and total thyroidectomy and bilateral central compartment lymph node dissection was performed. Histological and immunohistochemical analysis of the tumor demonstrated MMFTC. No metastasis was observed in lymph nodes isolated from the bilateral central compartment. Given the rarity of MMFTC, enhancing understanding and management of such tumors is crucial.
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Affiliation(s)
- Yonghui Wang
- Department of Thyroid and Breast Surgery, Weifang People's Hospital, Weifang, Shandong 261041, P.R. China
| | - Dandan Yin
- Department of Pathology, Weifang People's Hospital, Weifang, Shandong 261041, P.R. China
| | - Guifang Ren
- Department of Hospital Office, Weifang People's Hospital, Weifang, Shandong 261041, P.R. China
| | - Zhengjiang Wang
- Department of Pathology, Weifang People's Hospital, Weifang, Shandong 261041, P.R. China
| | - Fanhua Kong
- Department of Pathology, Weifang People's Hospital, Weifang, Shandong 261041, P.R. China
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Ma T, Wang R, Zhou X, Liu L, Pan A, Wang H, Huang L. Case reports of collision and composite carcinomas of the thyroid: an insight into their origin and clinical significance. BMC Endocr Disord 2023; 23:173. [PMID: 37580706 PMCID: PMC10424338 DOI: 10.1186/s12902-023-01409-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 07/06/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Collision and composite carcinomas of the thyroid are extremely rare, and their clinical and biological characteristics are poorly understood. CASE PRESENTATION The first case was a 41-year-old female patient with a right thyroid nodule. Pathological diagnosis was papillary thyroid carcinoma (PTC) and medullary thyroid carcinoma composite carcinoma. Surgical treatment was right thyroid lobectomy + left partial thyroidectomy + right central neck lymph node dissection. The second case was a 60-year-old female with bilateral thyroid nodules. Total thyroidectomy was performed, and the pathological diagnosis was thyroid collision carcinoma involving follicular thyroid carcinoma on the left side and PTC on the right side. The clinical, histological and gene changes of collision and composite carcinomas of the thyroid are poorly described. With different biological invasion characteristics, the ideal treatment and the prognosis is currently unknown and individualized treatment is necessary. CONCLUSIONS It is recommended that in composite carcinoma, each cancer is evaluated and treated according to the most severe tumor. Collision carcinoma should be treated as two separate synchronous primary tumors. For both collision and composite carcinomas of the thyroid, the follow-up after treatment should be extensive.
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Affiliation(s)
- Tao Ma
- Surgical Oncology, General Hospital of Ningxia Medical University, Yinchuan, 750000, Ningxia Province, China
| | - Ruixiao Wang
- Pathological Department, General Hospital of Ningxia Medical University, No.804 Shengli South Street, Xingqing District, Yinchuan, 750000, Ningxia Province, China
| | - Xu Zhou
- Ultrosound Department, General Hospital of Ningxia Medical University, Ningxia Province, Yinchuan, 750000, China
| | - Liqiang Liu
- Surgical Oncology, General Hospital of Ningxia Medical University, Yinchuan, 750000, Ningxia Province, China
| | - Aijing Pan
- Clinical Medical College, Ningxia Medical University, Yinchuan, 750000, Ningxia Province, China
| | - Hongmei Wang
- Department of Pharmacology, School of Medicine, Southeast University, Dingjiaqiao 87, Nanjing, 210009, Jiangsu, China.
| | - Lingyan Huang
- Pathological Department, General Hospital of Ningxia Medical University, No.804 Shengli South Street, Xingqing District, Yinchuan, 750000, Ningxia Province, China.
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Kawasaki K, Kai K, Tanaka N, Kido S, Ibi A, Minesaki A, Yamauchi M, Kuratomi Y, Aishima S, Nakashima M, Ito M. Collision tumor of a papillary and follicular thyroid carcinoma: a case report. Thyroid Res 2023; 16:24. [PMID: 37544981 PMCID: PMC10405457 DOI: 10.1186/s13044-023-00167-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 06/02/2023] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND Papillary thyroid carcinoma (PTC) and follicular thyroid carcinoma (FTC) are common differentiated thyroid cancers, but the detection of a collision tumor is an extremely rare event. CASE PRESENTATION The patient was a 69-year-old Japanese female with multiple cervical lymph node swellings and a thyroid tumor. Preoperative fine needle aspiration cytology of the enlarged lymph node revealed a cytological diagnosis of papillary thyroid carcinoma (PTC). A total thyroidectomy, right cervical dissection and paratracheal dissection were performed. Histopathological and immunohistochemical analyses of resected specimens revealed a collision tumor of PTC and FTC. Multiple metastases of papillary carcinoma were found in the dissected lymph nodes. In the PTC lesion, IHC for BRAF (V600E) was positive but negative for the FTC lesion. Genetic analyses further revealed a TERT promoter C228T mutation in PTC and a NRAS codon 61 mutation in FTC. The patient died of recurrent cancer 8 months after surgery. CONCLUSIONS A case of a collision tumor of PTC and FTC is very rare, and even fewer cases have been subjected to genetic scrutiny. The present case was successfully diagnosed by pathological examination using immunohistochemical and genetic analyses. The TERT promoter mutation in the PTC lesion was consistent with the aggressive behavior of the cancer.
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Affiliation(s)
- Kanako Kawasaki
- Department of Pathology & Microbiology, Saga University Faculty of Medicine, Saga, Japan
- Department of Otolaryngology - Head & Neck Surgery, Saga University Faculty of Medicine, Saga, Japan
| | - Keita Kai
- Department of Pathology, Saga University Hospital, Nabeshima 5-1-1, Saga, 849-8501, Japan.
| | - Nariyuki Tanaka
- Department of Otolaryngology - Head & Neck Surgery, Saga University Faculty of Medicine, Saga, Japan
| | - Shinichi Kido
- Department of Pathology & Microbiology, Saga University Faculty of Medicine, Saga, Japan
| | - Arisa Ibi
- Department of Pathology, Saga University Hospital, Nabeshima 5-1-1, Saga, 849-8501, Japan
| | - Akimichi Minesaki
- Department of Otolaryngology - Head & Neck Surgery, Saga University Faculty of Medicine, Saga, Japan
| | - Moriyasu Yamauchi
- Department of Otolaryngology - Head & Neck Surgery, Saga University Faculty of Medicine, Saga, Japan
| | - Yuichiro Kuratomi
- Department of Otolaryngology - Head & Neck Surgery, Saga University Faculty of Medicine, Saga, Japan
| | - Shinichi Aishima
- Department of Pathology & Microbiology, Saga University Faculty of Medicine, Saga, Japan
- Department of Pathology, Saga University Hospital, Nabeshima 5-1-1, Saga, 849-8501, Japan
| | - Masahiro Nakashima
- Department of Tumor and Diagnostic Pathology, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Masahiro Ito
- Department of Pathology, National Hospital Organization Nagasaki Medical Center, Omura, Japan
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Jiang W, Pan C, Guo W, Xu Z, Ni Q, Ruan Y. Pathologic collision of urinary bladder urothelial carcinoma with small cell carcinoma: a case report. Diagn Pathol 2023; 18:80. [PMID: 37434193 DOI: 10.1186/s13000-023-01369-x] [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: 05/02/2023] [Accepted: 06/27/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND Urothelial carcinoma is a major subtype of bladder cancer and small cell carcinoma (SCC) is a rare type of cancer in clinical practice. Pathologic collision of urinary bladder urothelial carcinoma with SCC is not common in clinical settings. CASE PRESENTATION Here, we report a patient with high-grade papillary carcinoma which changed to collision tumor with SCC. The patient underwent radical cystectomy; however, neck and mediastinum lymph nodes metastases were detected 11 months after the operation. The lymph nodes were diagnosed pathologically as SCC. Chemoradiotherapy was subsequently prescribed. Unfortunately, this patient died of COVID-19 in early 2023. DISCUSSION We hypothesized the mechanism underlying this pathological transformation. For patients with urothelial bladder cancer, pathological analysis should be conducted to allow standardized and persistent treatment. Moreover, drugs should be selected depending on the type of pathology, especially for patients who develop relapse, since collision tumor or other pathological tumors may be present. CONCLUSIONS We recommend that radical cystectomy be performed early enough for patients with non-muscle invasive bladder cancer, who are at a high risk of tumor recurrence. However, this conclusion needs to be validated in a larger number of patients.
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Affiliation(s)
- Wei Jiang
- Department of Urological Surgery, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, 225300, Jiangsu, P.R. China
| | - Chi Pan
- Department of General Surgery, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, 225300, Jiangsu, P.R. China
| | - Wei Guo
- Department of Urological Surgery, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, 225300, Jiangsu, P.R. China
| | - Zhen Xu
- Department of Urological Surgery, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, 225300, Jiangsu, P.R. China
| | - Qingtao Ni
- Department of Oncology, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, 225300, Jiangsu, P.R. China.
| | - Yashi Ruan
- Department of Urological Surgery, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, 225300, Jiangsu, P.R. China.
- Department of Oncology, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, 225300, Jiangsu, P.R. China.
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Bojoga A, Stănescu L, Badiu C. Collision tumors of the thyroid. A special clinical and pathological entity. Arch Clin Cases 2022; 8:84-90. [PMID: 34984231 PMCID: PMC8717004 DOI: 10.22551/2021.33.0804.10191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Thyroid collision tumors are rare entities that designate two histologically and morphologically distinct tumors that occur simultaneously or as metastases from other organs within the thyroid. Medullary and papillary carcinoma co-occurrence is the most frequent. Several theories tried to explain the pathogenic mechanisms underlining collision tumors, including the theory which assumes that one tumor predisposes the other, stem cell theory, and random effect theory, but their combination better explains the origin of these tumors. Hypotheses about common genetic behavior responsible for the pathogenesis have also been suggested, such as the involvement of germline mutation of RET (Rearranged during Transfection) proto-oncogene in medullary thyroid carcinoma and papillary thyroid carcinoma coexistence, but there is controversy on this topic. Management of thyroid collision tumors is challenging owing to the presence of two distinct tumors with different biological aggressiveness, treatments options, and prognosis, and needs to be individualized.
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Affiliation(s)
- Andreea Bojoga
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania; "C.I. Parhon" National Institute of Endocrinology, Bucharest, Romania
| | - Laura Stănescu
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania; "C.I. Parhon" National Institute of Endocrinology, Bucharest, Romania
| | - Corin Badiu
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania; "C.I. Parhon" National Institute of Endocrinology, Bucharest, Romania
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