Primary thyroid angiosarcoma: an unusual localization

Pasquale Petronella,Marco Scorzelli,Silvestro Canonico,Rossella Luise,Giuseppe Iannaci,Marco Ferretti,Fulvio Freda,Raffaele Rossiello,Rosaria Maria Anna Costanzo,Patrizia Sapere

doi:10.1186/1477-7819-10-73

Pasquale Petronella, Marco Scorzelli + Show 8 more

Open Access

https://doi.org/10.1186/1477-7819-10-73

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Abstract

The finding of thyroid nodules is a very common occurrence in routine clinical practice. Approximately 5% to 7% of the entire population have thyroid nodules. Vascular lesions are one of the most controversial issues in thyroid pathology. These include benign lesions such as hemangiomas and, rarely, malignant tumors such as angiosarcomas or undifferentiated angiosarcomatoid carcinomas. In particular, angiosarcoma of the thyroid gland is a rare, highly aggressive malignant vascular tumor and in Italy the greatest geographical incidence of this lesion is witnessed near the Alps. Here, a case of thyroid angiosarcoma in a 71-year-old man with a history of goiter for about 20 years is described. The unusual localization of this lesion, the difficulties in reaching a definitive diagnosis for this particular histological type of primary tumor and a history of long-standing multinodular goiter in thyroid of an older man from outside the Alpine region prompted us to report this case of thyroid angiosarcoma mainly to discuss surgical, histopathological and immunohistochemical features.

Highlights

The finding of thyroid nodules is a very common occurrence in routine clinical practice
We describe a case of thyroid angiosarcoma in a 71-year-old man with a history of goiter for 20 years, who decided to undergo operation for worsening dyspnea
The unusual localization of this lesion, the difficulties in reaching a definitive diagnosis for this particular histological type of primary tumor and a history of long-standing multinodular goiter in the thyroid of an older man from outside the Alpine region prompted us to report this case of thyroid angiosarcoma mainly to discuss surgical, histopathological and immunohistochemical features

Summary

Background

The finding of thyroid nodules is a very common occurrence in routine clinical practice. It constitutes only 2% to 10% of malignant thyroid tumors in Switzerland, Austria and Northern Italy [3,7,9] The prevalence of this lesion in Alpine regions may be due to iodine deficiency with a long history of endemic goiter [8]. The unusual localization of this lesion, the difficulties in reaching a definitive diagnosis for this particular histological type of primary tumor and a history of long-standing multinodular goiter in the thyroid of an older man from outside the Alpine region prompted us to report this case of thyroid angiosarcoma mainly to discuss surgical, histopathological and immunohistochemical features. Neoplastic cells were strongly positive for CD31, CD34, and factor VIII-related antigen, showing evidence of their endothelial differentiation (Figure 4) Diagnosis of this condition can be difficult as the histological features may mimic other malignant vascular lesions. Our patient was monitored and follow-up was started but it was too short to be meaningful because our patient died about 3 months later as a result of of cardiac and respiratory complications related to his oncologic condition

Conclusions

Findings

Coltrera MD