Abstract
Background: The aim of this retrospective study was to investigate clinical and pathological characteristics of the tall cell variant of papillary thyroid carcinoma compared to conventional variants. Methods: The clinical records of patients who underwent surgical treatment between 2009 and 2015 were analyzed. The patients were divided into two groups: those with a histopathological diagnosis of tall cell papillary carcinoma were included in Group A, and those with a diagnosis of conventional variants in Group B. Results: A total of 35 patients were included in Group A and 316 in Group B. All patients underwent total thyroidectomy. Central compartment and lateral cervical lymph node dissection were performed more frequently in Group A (42.8% vs. 18%, p = 0.001, and 17.1% vs. 6.9%, p = 0.04). Angiolymphatic invasion, parenchymal invasion, extrathyroidal extension, and lymph node metastases were more frequent in Group A, and the data reached statistical significance. Local recurrence was more frequent in Group A (17.1% vs. 6.3%, p = 0.02), with two patients (5.7%) in Group A showing visceral metastases, whereas no patient in Group B developed metastatic cancer (p = 0.009). Conclusions: Tall cell papillary carcinoma is the most frequent aggressive variant of papillary thyroid cancer. Tall cell histology represents an independent poor prognostic factor compared to conventional variants.
Highlights
Received: 24 November 2020Accepted: 22 December 2020Published: 28 December 2020Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.Papillary thyroid carcinoma (PTC) is the most common malignant endocrine tumor.The prognosis for patients with PTC is almost the same as that of individuals who never had cancer, and only a few patients with PTC are affected by a biologically aggressive tumor [1,2]
tall cell variant (TCV) is generally considered a more aggressive variant of PTC and frequently has lymph node metastases and/or distant metastases, with a poorer prognosis [12,13,14] compared to conventional PTC
Our patients with a diagnosis of TCV-PTC showed larger tumor diameter and higher frequency of angiolymphatic invasion, extrathyroidal invasion, and lymph node metastases at the time of surgery than conventional PTC (cPTC) patients, and this resulted in a higher rate of local recurrence and distant metastases and in a less favorable clinical outcome
Summary
Received: 24 November 2020Accepted: 22 December 2020Published: 28 December 2020Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.Papillary thyroid carcinoma (PTC) is the most common malignant endocrine tumor.The prognosis for patients with PTC is almost the same as that of individuals who never had cancer, and only a few patients with PTC are affected by a biologically aggressive tumor [1,2]. The most common of PTC aggressive subtypes is the tall cell variant (TCV). The definition of TCV includes the presence of a tumor whose cells are two to three times as tall as they are wide, eosinophilic cytoplasm, basilar-oriented nuclei, and the nuclear features of PTC [3,10,11]. TCV is generally considered a more aggressive variant of PTC and frequently has lymph node metastases and/or distant metastases, with a poorer prognosis [12,13,14] compared to conventional PTC (cPTC). The aim of this retrospective study was to investigate the clinical and pathological characteristics of TCV-PTC compared to conventional variants
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