Thyroid and Parathyroid Neoplasms with Lipomatous Stroma: Report of Three Cases and Review of the Literature

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S33-S33
Author(s):  
M Toprak ◽  
M Kashi ◽  
J Villanueva ◽  
M Wrzolek ◽  
G Tong ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Thyroid Carcinoma ◽  
Malignant Tumors ◽  
Diagnostic Error ◽  
Needle Aspiration ◽  
Parathyroid Glands ◽  
Fatty Tissue ◽  
Thyroid Carcinomas ◽  
Preoperative Diagnostic ◽  
Poorly Differentiated

Abstract Introduction/Objective Tumors with mixed adipose tissue and epithelial components are rare in thyroid and parathyroid glands. Most of them are benign and referred to as adenolipoma (or lipoadenoma). A handful of malignant tumors of thyroid follicular cell origin have been reported with abundant adipose tissue known as thyroid carcinoma with lipomatous stroma (TCLS). Adenolipomas of thyroid or TCLS are usually manifested as large thyroid nodules and evaluated by fine needle aspiration biopsy (FNAB) which frequently yield low-cellularity samples due to abundant adipose tissue. On FNAB, the adipose tissue usually interpreted as contamination of subcutaneous or perithyroid origin. Similarly, adenolipomas of the parathyroid are not frequently identified because of presence of adipose tissue which is a feature associated with normal parathyroid glands. Therefore, these tumors are not often correctly diagnosed preoperatively. For that reason, pathologist should report additional cases about this rare entity to increase our understanding and to decrease preoperative diagnostic error. Methods We report three cases of thyroid and parathyroid tumors with abundant adipose tissue with sonographic, cytologic and histologic features along with literature review. Results Among the reported cases in the literature and our cases; 10 out of 17 cases of thyroid carcinoma with lipomatous stroma are papillary thyroid carcinomas (58.8%), 3 out of 17 cases are papillary microcarcinomas (17.6%), 2 out of 17 cases are noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) (11.7%), and 2 out of 17 cases are minimally invasive follicular carcinomas (11.7%). No cases of poorly differentiated or anaplastic thyroid carcinomas have been reported. Conclusion Lipomatous stroma in thyroid carcinoma appears to be associated with differentiated carcinomas since no reported cases of poorly differentiated or anaplastic thyroid carcinomas are present to our knowledge. Although the presence of fatty tissue does not appear to alter the prognosis of these lesions, the question of the histogenesis of the adipose component is intriguing. Awareness of this unusual feature and increased utilization of multimodal approaches in the evaluation of this entity may increase preoperative detection and the understanding of the histogenesis and its possible significance.

scholarly journals Thyroid Carcinoma on the Side of the Absent Lobe in a Patient with Thyroid Hemiagenesis

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Hiroki Sato ◽  
Kiyoaki Tsukahara ◽  
Ray Motohashi ◽  
Midori Wakiya ◽  
Hiromi Serizawa ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Papillary Carcinoma ◽  
Thyroid Tissue ◽  
Needle Aspiration ◽  
Left Lobe ◽  
Thyroid Hemiagenesis ◽  
Poorly Differentiated ◽  
Node Metastases ◽  
Right Lobe ◽  
The Right

Background. Thyroid carcinoma complicated by hemiagenesis is very rare, and previous reports have not described this cancer on the side of the absent lobe. Methods and Results. We report the case of a 64-year-old woman in whom left thyroid hemiagenesis was discovered incidentally during investigations of abnormal sensation during swallowing. A tumorous 1.4 cm lesion was also found on the side of the absent lobe, left of the isthmus. Fine-needle aspiration biopsy revealed class V papillary carcinoma, but no lymph node metastases. Total thyroidectomy was performed for stage cT1bN0M0 carcinoma. Histopathology revealed normal thyroid tissues in the right lobe and isthmus, while the left lobe was absent. The mostly papillary carcinoma was adjacent to the truncated thyroid tissue, with a portion histologically consistent with poorly differentiated carcinoma. Conclusions. All previously reported cases of thyroid cancer complicated by hemiagenesis have represented carcinoma occurring within the present lobe. This case is extremely rare.

scholarly journals Synchronous intrathyroidal parathyroid carcinoma and thyroid carcinoma: case report and review of the literature

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nadia De Falco ◽  
Giuseppe Santangelo ◽  
Fabrizio Chirico ◽  
Angelo Cangiano ◽  
Maria Giulia Sommella ◽  
...  
Keyword(s):  
Literature Review ◽  
Thyroid Carcinoma ◽  
Papillary Carcinoma ◽  
Parathyroid Carcinoma ◽  
Malignant Tumors ◽  
Gamma Probe ◽  
Differentiated Thyroid Carcinoma ◽  
Thyroid Carcinomas ◽  
First Case ◽  
Well Differentiated

Abstract Background Parathyroid carcinoma is a rare endocrine malignancy, rarer when synchronous with a non medullary well differentiated thyroid carcinoma. Parathyroid carcinoma accounts of 0.005% of all malignant tumors and it is responsible for less than 1% of primary hyperparathyroidism. The intrathyroidal localization of a parathyroid gland is not frequent with a reported prevalence of 0.2%. Carcinoma of parathyroids with intrathyroidal localization represents an even rarer finding, reported in only 16 cases described in literature. The rare constellation of synchronous parathyroid and thyroid carcinomas has prompted us to report our experience and perform literature review. Case presentation We herein report a case of a 63-years-old man with multinodular goiter and biochemical diagnosis of hyperparathyroidism. Total thyroidectomy with radio-guide technique using gamma probe after intraoperative sesta-MIBI administration and intraoperative PTH level was performed. The high radiation levels in the posterior thyroid lobe discovered an intrathyroidal parathyroid. Microscopic examination revealed a parathyroid main cell carcinoma at the posterior thyroidal left basal lobe, a classic papillary carcinoma at the same lobe and follicular variant of papillary carcinoma at the thyroidal right lobe. To the best of our knowledge, this is the first case documenting a synchronous multicentric non medullary thyroid carcinomas and intrathyroidal parathyroid carcinoma. Conclusions Our experience was reported and literature review underlining challenging difficulties in diagnostic workup and surgical management was carried out.

Problems and Controversies in the Histopathology of Thyroid Carcinomas of Follicular Cell Origin

2009 ◽  
Vol 133 (5) ◽  
pp. 683-691
Author(s):  
Ronald Ghossein
Keyword(s):  
Thyroid Carcinoma ◽  
English Language ◽  
Follicular Carcinoma ◽  
Molecular Data ◽  
Follicular Cell ◽  
Clinical Value ◽  
Thyroid Carcinomas ◽  
Poorly Differentiated ◽  
Disease Entities

Abstract Context.—Despite past and recent efforts, many problems and controversies remain in the classification of thyroid carcinomas of follicular cell origin. These controversies have an impact on the prognosis and therapy of patients with thyroid carcinoma as well as on the development of robust cutting-edge research aimed at better outcome and quality of life. Objective.—To focus on 3 contentious areas with significant clinical value: the follicular variant of papillary thyroid carcinoma, the extent of invasion in follicular carcinoma, and the poorly differentiated thyroid carcinomas. Data Sources.—The published English language literature was reviewed. Conclusions.—Recent data show that prognosis and therapy for many disease entities can be better delineated if a meticulous microscopic examination is performed. An accurate assessment of the extent of invasion (especially vascular) is crucial. Proliferative grading (ie, mitosis and necrosis) is of high prognostic value and should be looked for in every specimen. In addition, molecular data gathered to date can help reassess these tumors at the histologic level. Classification proposals based on personal experience rather than adequate and careful clinical follow-up should be discouraged.

scholarly journals Horner syndrome as a manifestation of thyroid carcinoma: a rare association

2013 ◽  
Vol 57 (6) ◽  
pp. 483-485 ◽  
Author(s):  
Bernardo Pereira ◽  
Tiago Silva ◽  
Henrique Luiz ◽  
Isabel Manita ◽  
Luísa Raimundo ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Thyroid Neoplasms ◽  
Needle Aspiration ◽  
Differentiated Thyroid Carcinoma ◽  
Imaging Data ◽  
Horner Syndrome ◽  
Thyroid Mass ◽  
Poorly Differentiated ◽  
Thyroid Malignancies ◽  
Neck Vessels

An 82-year-old patient presented a progressively growing hard thyroid nodule, and left ptosis. Additionally, ophthalmologic evaluation revealed ipsilateral miosis, diagnostic findings of Horner syndrome. Computerized tomography revealed a 7.5-cm thyroid mass infiltrating the main neck vessels. Although clinical and imaging data were suggestive of poorly differentiated thyroid carcinoma, fine-needle aspiration led to the diagnosis of papillary carcinoma. Paliative care was proposed to the patient due to the advanced stage of the neoplasm and to significant comorbidities. Horner syndrome is an infrequent manifestation of thyroid disorders and benign etiologies are more often implied. Malignant thyroid neoplasms represent a rare cause of Horner syndrome. However, an appropriate and prompt diagnosis is paramount for timely treatment of rare thyroid malignancies.

Circulating Cytokeratin 19 Fragments in Patients with benign Nodules and Carcinomas of the Thyroid Gland

2008 ◽  
Vol 23 (1) ◽  
pp. 54-57 ◽  
Author(s):  
L. Giovanella ◽  
L. Ceriani ◽  
A. Ghelfo ◽  
M. Maffioli
Keyword(s):  
Thyroid Carcinoma ◽  
Thyroid Nodules ◽  
Differentiated Thyroid Carcinoma ◽  
Cytokeratin 19 ◽  
Thyroid Carcinomas ◽  
Poorly Differentiated ◽  
Benign Nodules ◽  
Thyroid Malignancies ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

Cytokeratin 19 (CK19) is an acidic protein of 40 kDa that is part of the cytoskeleton of epithelial cells and is highly expressed by differentiated thyroid carcinomas, mainly of the papillary subtype. The soluble fragments of CK19 (Cyfra 21.1) can be measured by immunometric assays employing specific monoclonal antibodies. The present study was planned to assess the serum expression of Cyfra 21.1 in patients with benign thyroid nodules and thyroid malignancies. We enrolled 135 patients with histologically proven benign thyroid nodules (n=79) and thyroid carcinomas (n=56). No differences were found in serum Cyfra 21.1 levels between patients with benign nodules and patients with carcinomas. When thyroid malignancies were subdivided according to tumor histology, serum Cyfra 21.1 increased significantly from classical differentiated thyroid carcinomas (papillary or follicular) to less differentiated or undifferentiated carcinomas (poorly differentiated or anaplastic). CK19 release into the bloodstream is strongly related to the apoptotic pathway, and particularly to hyperproliferation-related apoptosis. These pathways characterized anaplastic and poorly differentiated thyroid carcinoma but not classical forms of differentiated thyroid carcinoma. Consequently, Cyfra 21.1 may be regarded as a circulating marker of poorly differentiated and anaplastic thyroid carcinoma. Additionally, a role of Cyfra 21.1 as a dedifferentiation marker in patients with classical differentiated thyroid carcinomas may be postulated and should be explored by further focused studies.

Genetic profile of advanced thyroid cancers in relation to distant metastasis

2020 ◽  
Vol 27 (5) ◽  
pp. 285-293 ◽  
Author(s):  
Eyun Song ◽  
Dong Eun Song ◽  
Jonghwa Ahn ◽  
Tae Yong Kim ◽  
Won Bae Kim ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Distant Metastasis ◽  
Distant Metastases ◽  
Thyroid Tumors ◽  
Primary Tumors ◽  
Thyroid Cancers ◽  
Histone Methyltransferases ◽  
Thyroid Carcinomas ◽  
Poorly Differentiated

Major clinical challenges exist with differentiated thyroid cancers with distant metastases or rare but aggressive types, such as poorly differentiated thyroid carcinomas and anaplastic thyroid carcinomas. The precise characterization of the mutational profile in these advanced thyroid cancers is crucial. Samples were collected from primary tumors and distant metastases of 64 patients with distant metastases from differentiated thyroid cancer, poorly differentiated thyroid carcinoma, or anaplastic thyroid carcinoma. Targeted next-generation sequencing was performed with 50 known thyroid-cancer-related genes. Of the 82 tissues, 63 were from primary tumors and 19 from distant metastases. The most prevalent mutation observed from the primary tumors was TERT promoter mutation (56%), followed by BRAF (41%) and RAS (24%) mutations. TP3 was altered by 11%. Mutations in histone methyltransferases, SWI/SNF subunit–related genes, and PI3K/AKT/mTOR pathway-related genes were present in 42%, 12%, and 22%, respectively. When the mutational status was analyzed in 15 matched pairs of thyroid tumors and their matched distant metastases and one pair of distant metastases with two distinct sites, the concordance was high. A similar frequency of mutations in TERT promoter (58%) and BRAF (42%) as well as histone methyltransferases (37%), SWI/SNF subunits (10%), and PI3K/AKT/mTOR pathway (26%) were noted. The same main, early and late mutations were practically always present in individual primary tumor–metastasis pairs. Enrichment of TERT promoter, BRAF, and RAS mutations were detected in highly advanced thyroid cancers with distant metastasis. The genetic profiles of primary thyroid tumors and their corresponding distant metastases showed a high concordance.

A Clinical Approach to the Parapharyngeal Space

2017 ◽  
Vol 8 (1) ◽  
pp. 1-4
Author(s):  
AM Shivakumar ◽  
Praveen D Shivanandappa ◽  
Veena P Doddamane ◽  
KS Munish ◽  
BS Yogeesha
Keyword(s):  
Parapharyngeal Space ◽  
Malignant Tumors ◽  
Imaging Study ◽  
Needle Aspiration ◽  
Benign Tumors ◽  
Clinical Approach ◽  
Preoperative Diagnostic ◽  
Clinicopathological Profile ◽  
Needle Aspiration Cytology ◽  
Clinical Records

ABSTRACT Aim To present the clinicopathological profile, surgical management, and the outcome of parapharyngeal space (PPS) neoplasms in 14 patients. Materials and methods This is a retrospective review of the clinical records of 14 patients treated for PPS tumors. The age of patients ranged from 24 to 54 years, with female to male ratio of 1.3:1. The commonest clinical presentation was a slowgrowing, painless neck swelling. The preoperative protocol was based on: (1) imaging study to establish site, size, and anatomical relationships. (2) Fine-needle aspiration cytology (FNAC) was performed to determine the nature of the mass. Details of the management, morbidity, and outcome of these patients are presented. Results A total of 85.7% of the PPS neoplasms were benign and 14.2% were malignant. Majority of the benign tumors were of neurogenic origin. The histocytopathology confirmed 12 (85.7%) of these diagnoses (2 patients were with “nondiagnostic” result). The positive predictive value of the FNAC was 83.3% for benign tumors and 100% for malignant tumors. In 6 patients (60%), a transcervical surgery was performed. Three patients (30%) underwent transparotid–transcervical surgery for a pleomorphic adenoma of the deep lobe of the parotid gland in the prestyloid space and transcervical–transmandibular approach was taken in 1 case (10%). Postoperative complications occurred in 3 out of 10 patients (33.3%). Conclusion The results of our study are in agreement with other studies reported in the literature and confirm the need to follow a careful preoperative diagnostic protocol that must take advantage of imaging studies (computed tomography, magnetic resonance imaging) and of cytology FNAC, in order to plan surgical treatment with a safe approach and that reduces complications, esthetic and functional damage, and the risk of recurrence. How to cite this article Shivanandappa PD, Doddamane VP, Munish KS, Yogeesha BS, Shivakumar AM. A Clinical Approach to the Parapharyngeal Space. Int J Head Neck Surg 2017;8(1):1-4.

Fine Needle Aspiration of Poorly Differentiated Oxyphilic (Hürthle Cell) Thyroid Carcinoma

2006 ◽  
Vol 50 (5) ◽  
pp. 560-562 ◽  
Author(s):  
Mohiedean Ghofrani ◽  
Julie Ann Sosa ◽  
Idris Tolgay Ocal ◽  
Cesar Angeletti
Keyword(s):  
Thyroid Carcinoma ◽  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Fine Needle ◽  
Hürthle Cell ◽  
Poorly Differentiated
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