Is an aggressive approach justified in the management of an aggressive cancer-the squamous cell carcinoma of thyroid?

Chintamani Chintamani,Anju Bansal,Jaiprakash Singh,Nidhi Sugandhi,Pranjal Kulshreshtha,Dinesh Bhatnagar,Sunita Saxena

doi:10.1186/1477-7800-4-8

Abstract

BackgroundPrimary squamous cell carcinoma of the thyroid is an extremely rare neoplasm, with less than 50 cases reported in the world literature. The prognosis is poor with a median survival of less than six months. The death is usually secondary to progression of local disease as distant metastases are rare.Case reportsThree cases, two males and one female presenting with sudden increase in the size of long standing thyroid swellings and associated pressure effects on the aero-digestive tract are reported. Exhaustive clinical, endoscopic, and radiological examinations did not reveal any primary site of squamous-cell carcinoma as the likely source of the metastases, or of any contiguous spread from neighboring structures. Two cases were managed by combined modality therapy including curative surgery with radiotherapy and one by radiotherapy alone.ConclusionPrimary squamous cell carcinoma is a rare malignancy with a poor outcome inspite of combined modality therapy. Out of three reported cases, two succumbed to their disease within less than one year. Aggressive surgery in the form of curative resection along with adjuvant radiotherapy is recommended, the tumor being chemo resistant.

Highlights

Primary squamous cell carcinoma of the thyroid is an extremely rare neoplasm, with less than 50 cases reported in the world literature
Primary squamous cell carcinoma (SCC) of thyroid gland is an extremely rare neoplasm, representing less than 1% of all primary thyroid malignancies [1]. The evaluation of this disease involves a combination of endoscopy and radiographic examination by computerized tomography to exclude SCC that has spread from adjacent upper aerodigestive tract sites, as well as metastasis from distant sites such as lungs, kidneys or gastrointestinal tract [2]
Case 1 A 50-year-old lady presented with a rapid increase in the size of a thyroid swelling of 20 years duration associated with pain, fever, dysphagia, hoarseness of voice and stridor

Summary

Conclusion

Primary squamous cell carcinoma of thyroid is a rare and aggressive tumor with dismal outcome. The outcome is dismal, aggressive surgery along with adjuvant radiotherapy are recommended in the management of this rare and aggressive cancer for optimum outcome

Background

Discussion

Findings

Zhou XH

Goldman RL