Tall cell variant of papillary thyroid carcinoma: current evidence on clinicopathologic features and molecular biology.

Xiaofei Wang,Wenli Cheng,Jingdong Li,Chongqing Liu

doi:10.18632/oncotarget.8215

Xiaofei Wang, Wenli Cheng + Show 2 more

Open Access

https://doi.org/10.18632/oncotarget.8215

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Abstract

Tall cell variant (TCV) of papillary thyroid carcinoma (PTC) has been recognized for the past few decades as an entity showing aggressive biological behavior; however, there is considerable controversy regarding the definition, clinical and pathological features of TCV because of its rarity and difficult diagnosis. No clinical features can accurately diagnose TCV. Thus, the results of histocytology, immunohistochemistry and molecular genetics tests have important clinical implications for diagnosis. Given the aggressiveness and the increased recurrence and poor survival rates, more aggressive treatment approach and rigorous follow-up is required for patients with TCV. In the present article, we undertook a comprehensive review to summarize and discuss the various aspects of this variant, from morphology to immunohistochemistry, and molecular abnormalities from a practical and daily practice-oriented point of view.

Highlights

Most of papillary thyroid carcinoma (PTC) are indolent with excellent long-term survival, several histological variants of PTC have been found to be associated with more aggressive biologic behavior and poorer prognosis [1, 2]
Most studies [5, 26, 28, 39] demonstrated Tall cell variant (TCV) as a more aggressive variant of PTC with higher recurrence and poorer survival compared with classic PTC (cPTC)
Compared to cPTC, there was a higher rate of P53 protein overexpression in the TCV samples and the p53 mutant positivity correlated with increased rate of local and distant recurrence [17]

Summary

INTRODUCTION

Most of papillary thyroid carcinoma (PTC) are indolent with excellent long-term survival, several histological variants of PTC have been found to be associated with more aggressive biologic behavior and poorer prognosis [1, 2]. Tall cell variant (TCV), the most common aggressive variant of PTC, frequently has vascular invasion, extrathyroidal extension, lymph node metastasis, and distant metastases [3,4,5,6,7,8,9], and its 10-year overall and disease-free survival has been reported to be approximately 10% lower than that of classic PTC (cPTC) [7]. Most studies [5, 26, 28, 39] demonstrated TCV as a more aggressive variant of PTC with higher recurrence and poorer survival compared with cPTC. Compared to cPTC, there was a higher rate of P53 protein overexpression in the TCV samples and the p53 mutant positivity correlated with increased rate of local and distant recurrence [17] Together, those results provided a rational basis for to distinguish the aggressive subtype from cPTC at a molecular level. In order to provide valuable diagnostic, prognostic, and therapeutic information, further study needs to be done for more precise and specific biomarkers

CONCLUSIONS

Findings

MATERIALS AND METHODS