1/17. Encapsulated follicular variant of papillary thyroid carcinoma with bone metastases.Although true follicular thyroid carcinoma is known to metastasize via the bloodstream and give rise to bone and lung metastases, such a pattern of spread is rare in papillary thyroid carcinoma. The follicular variant of papillary thyroid carcinoma (FVPTC) is believed to behave in a clinical manner similar to usual or classical papillary cancer and to follow a similar indolent course. There have been a few reports of "aggressive" FVPTC wherein follicular patterned tumors with nuclear features of papillary carcinoma have metastasized hematogenously; these neoplasms have been diffusely invasive or multicentric in the thyroid. We report five cases of FVPTC, which were encapsulated and simulated grossly and microscopically follicular adenomas. In two of these, the primary was discovered after clinical presentation of bone metastases. In three others, bony metastases (without other nonosseous metastases) arose 7 to 17 years after thyroid lobectomy for lesions initially diagnosed as follicular adenoma In retrospect, these three encapsulated lesions had vascular invasion. We wish to bring attention to these innocuous-appearing lesions, which, although sharing nuclear features of papillary cancer, behave clinically in an unexpectedly malignant fashion.- - - - - - - - - - ranking = 1keywords = cancer, neoplasm (Clic here for more details about this article) |
2/17. Macrofollicular encapsulated variant of papillary thyroid carcinoma as a potential pitfall in histologic and cytologic diagnosis. A report of three cases.BACKGROUND: Macrofollicular encapsulated papillary carcinoma (MEPC) is a variant of papillary carcinoma with a favorable clinical course. Its characteristic histologic pattern could be mistaken for that of an adenoma or hyperplastic nodule. Fine needle aspiration of this neoplasm may not show the particular nuclear features of papillary carcinoma, so the cytologic diagnosis may be benign. case reports: Three paradigmatic cases of MEPC with different histologic patterns, diagnosed as a follicular neoplasm using fine needle aspiration biopsy (FNAB) are described. Preoperative cytology showed scattered clusters of thyrocytes with prominent nuclear pleomorphism and irregularities and focal oxyphilic changes mixed with colloid and aggregates of typical thyrocytes. The histologic picture exhibits small, neoplastic foci showing a microfollicular structure within an encapsulated neoplasm with a macrofollicular pattern. In microfollicular areas obvious nuclear pseudoinclusions were seldom observed. CONCLUSION: MEPC represents a challenging tumor subtype that infrequently shows the pathognomonic cytologic characteristics of papillary carcinoma, and therefore it is much more difficult to diagnose with a FNAB. Nuclear pleomorphism and irregularity of the nuclear membrane of thyrocytes are clues to this variant, although in some cases a clear-cut preoperative diagnosis cannot be made.- - - - - - - - - - ranking = 0.1189318889078keywords = neoplasm (Clic here for more details about this article) |
3/17. Cribriform-morular variant of papillary carcinoma: the sporadic counterpart of familial adenomatous polyposis-associated thyroid carcinoma. A case report with clinical and molecular genetic correlation.The increased incidence of thyroid carcinomas in familial adenomatous polyposis (FAP) patients is well recognised. These thyroid neoplasms display distinctive clinicopathological features and generally show good prognostic outcome. Recently, unusual sporadic tumours that share the morphological features of FAP-associated thyroid carcinomas have also been described. In this report, we document a case of a thyroid tumour in a previously well, 46-year-old female. histology revealed a circumscribed neoplasm composed of tubular, papillary, cribriform and solid areas. The pseudostratified columnar tumour cells showed occasional nuclear grooves and rare nuclear inclusions. immunohistochemistry showed positive staining with antibodies to cytokeratin AE1/AE3, oestrogen and progesterone receptor proteins. Focal immunoreactivity was also noted with antibodies to thyroglobulin, epithelial membrane antigen, 34betaE12 and cytokeratin CK7. The absence of polyps on colonoscopy and germline mutation in the adenomatous polyposis coli (APC) gene provides evidence that this tumour represents the sporadic counterpart of FAP-associated thyroid carcinoma. The patient is well with no evidence of disease 7 months following resection of the tumour. The differential diagnoses and molecular genetics of this unusual tumour are discussed.- - - - - - - - - - ranking = 0.079287925938533keywords = neoplasm (Clic here for more details about this article) |
4/17. amiodarone-induced thyrotoxicosis and thyroid cancer: clinical, immunohistochemical, and molecular genetic studies of a case and review of the literature.amiodarone-induced thyrotoxicosis (AIT) is a well-known complication of amiodarone treatment found in 3% to 12% of patients. Two types of AIT have been described, each associated with a distinct histologic pattern of thyroid involvement. Type 1, which typically develops in the background of pre-existing thyroid disease, is due to iodine-induced excess thyroid hormone synthesis, whereas type 2 is due to destructive thyroiditis. The prevalence of thyroid cancer in patients with AIT is unknown. We report a case of papillary thyroid carcinoma associated with type 2 AIT.- - - - - - - - - - ranking = 2.4008900925768keywords = cancer (Clic here for more details about this article) |
5/17. Insular carcinoma of the thyroid with jugular vein invasion.BACKGROUND: Gross angioinvasion with intraluminal tumor thrombus is rarely seen in thyroid cancer, with few cases reported in the literature. methods: We report an insular carcinoma of the thyroid displaying this aggressive local invasion and angioinvasion of the internal jugular chain. Complete surgical removal of the intraluminal disease, regional metastasis, and primary tumor was carried out. RESULTS: Adjuvant external beam radiation therapy and iodine-131 were administered, and the patient died with pulmonary metastases 30 months after surgery. No locoregional recurrence was noted at last follow-up. CONCLUSIONS: Treatment of insular carcinoma of the thyroid with invasion of the internal jugular vein is amenable to surgical resection. Postoperative radioactive iodine and external beam radiotherapy can achieve locoregional disease control and prolonged survival.- - - - - - - - - - ranking = 0.48017801851537keywords = cancer (Clic here for more details about this article) |
6/17. Clinical curiosity: cribriform-morular variant of papillary thyroid carcinoma.BACKGROUND: There is an increasing awareness of the association of papillary thyroid carcinoma and familial adenomatous polyposis (FAP). Although the incidence is rare, most tend to occur in women. Several authors have described a distinctive histologic variant of papillary thyroid carcinoma, the cribriform-morular variant, which is associated with FAP but also may be encountered in patients with non-FAP. This diagnosis may precede the symptoms of colorectal polyposis. methods: A healthy 36-year-old woman was seen with a left thyroid nodule, and a 34-year-old woman with FAP was seen with a right thyroid nodule; both masses were suspicious for papillary thyroid carcinoma. Both patients underwent total thyroidectomy. RESULTS: Pathologic examination of both specimens revealed papillary thyroid carcinoma, cribriform-morular variant. The first patient subsequently underwent colonoscopy, which was negative for polyposis. CONCLUSIONS: patients diagnosed with the cribriform-morular variant of papillary thyroid cancer should be screened for the presence of FAP.- - - - - - - - - - ranking = 0.48017801851537keywords = cancer (Clic here for more details about this article) |
7/17. Macrofollicular encapsulated papillary thyroid carcinoma--a case report.Macrofollicular encapsulated papillary thyroid carcinoma (MEPC) is a rare variant of papillary carcinoma of thyroid with a favourable clinical course. It could be mistaken for a follicular neoplasm or a hyperplastic nodule. We report cytological and histopathological features of this rare variant of papillary carcinoma in a 22 year old female with brief review of literature.- - - - - - - - - - ranking = 0.039643962969266keywords = neoplasm (Clic here for more details about this article) |
8/17. Importance of thyroglobulin levels for diagnosis and monitoring of follicular thyroid carcinoma in an adolescent with severe iodine deficiency.Optimal management of differentiated thyroid cancer in childhood is undetermined. During monitoring of thyroid carcinoma, serum thyroglobulin (hTG) levels provide valuable information. hTG levels not only increase in differentiated thyroid cancers but also in iodine deficiency because of compensation by the thyroid gland. A 14.6 year-old girl was diagnosed with nodular goiter, subclinical hypothyroidism and severe iodine deficiency. She had a very high hTG level. Despite benign fine-needle aspiration biopsy (FNAB), because the hTG level was still very high after treatment with LT4, thyroidectomy was undergone. Cytopathological examination showed minimally invasive follicular thyroid carcinoma. During follow-up, to exclude the presence of persistent/recurrent disease, the hTG level rose to an undesirably high level after withdrawal of TSH suppressive therapy, and radioiodine ablation therapy was applied. This report shows that even if there is an explanation for nodular goiter and high hTG levels, such as iodine deficiency, malignancy cannot be ruled out without thyroidectomy. FNAB is not reliable especially in iodine deficient areas. serum hTG measurement is a valuable tool for both diagnosis and follow-up of differentiated thyroid carcinoma in children.- - - - - - - - - - ranking = 0.96035603703073keywords = cancer (Clic here for more details about this article) |
9/17. Thyroid carcinoma with insular component: report of three cases with different clinical pictures.Insular carcinoma of the thyroid is situated morphologically and biologically in an intermediate position between the well-differentiated and undifferentiated tumors and presents a variable clinical course in a widely heterogeneous spectrum. The present cancer staging system (TNM) for thyroid cancer considers differentiated and undifferentiated tumors while ignoring this intermediate type, which is also called poorly differentiated tumor. In addition to the limited data on this rare disease, some poorly differentiated thyroid tumors contain differentiated cancer areas at various rates. These factors may cause difficulties in estimating disease aggressiveness and prognosis. To solve this problem, various microscopic and immunohistochemical parameters can be assessed. In this paper we describe 3 patients affected by thyroid carcinoma with an insular component, who presented different clinical pictures. When these cases were examined, the TNM system failed in stage grouping for poorly differentiated thyroid tumors. Case 1 and case 2 had similar clinical stages according to the TNM staging system for differentiated tumors, but had different prognoses. Case 3, with more limited disease, had the highest rate of poorly differentiated areas but the lowest Ki-67 proliferation index. In conclusion, it is difficult to make claims about the clinical behavior and prognosis of thyroid carcinoma with an insular component based on the 3 cases reported in this study, but it can be speculated that there is a gap in the TNM system with regard to the staging of insular thyroid carcinoma. In this situation the assessment of microscopic and immunohistochemical features of the tumor may help to predict disease aggressiveness and patient risk. However, it is clear that there is a need for large-scale studies evaluating the prognostic importance of histopathological and immunohistochemical features in determining risk groups.- - - - - - - - - - ranking = 1.4405340555461keywords = cancer (Clic here for more details about this article) |
10/17. Metastatic papillary thyroid carcinoma presenting as a primary renal neoplasm.Clinically detectable thyroid cancer metastatic to the kidney is rare, with only six cases reported in the medical literature. Four of these have been follicular carcinoma, one papillary carcinoma, and one described as a thyroid adenoma. All of these had known thyroid neoplasms prior to development of their renal metastases. We report herein a seventh case of thyroid carcinoma metastatic to the kidney, unique in that the diagnosis of the kidney metastasis preceded the knowledge of the primary thyroid neoplasm. Furthermore, the follicular variant of papillary cancer, present in this case, has not been previously described in renal metastases from thyroid cancer. Treatment of the kidney metastases led to the subsequent discovery and treatment of the primary thyroid cancer. The patient underwent nephrectomy followed by total thyroidectomy, and is alive and disease-free 3 years postoperatively. Thyroid cancer metastatic to the kidney is rare clinically, but can be amenable to treatment with good long term results.- - - - - - - - - - ranking = 2.6387538703924keywords = cancer, neoplasm (Clic here for more details about this article) |
| | Next -> |