Primary Papillary Carcinoma Research Articles

Primary papillary carcinoma originated from a branchial cleft cyst

Although branchial cleft cysts are common, papillary carcinomas arising from them are rare. Here we report a 41-year-old woman with papillary carcinoma originating from a right lateral branchial cleft cyst without any evidence of a papillary carcinoma in the thyroid gland. The patient underwent right lateral neck dissection followed by total thyroidectomy. We then confirmed papillary carcinoma arising from the branchial cleft cyst through microscopic and immunohistochemical staining with thyroglobulin (TG), thyroid-associated transcription factor-1 (TTF-1) and p63. It is the 10th case worldwide describing papillary carcinoma in a branchial cleft cyst with a review of the literature on the features of the disease and discussion of the role of immunohistochemical staining with TG, TTF -1 and p63. In conclusion, it should be emphasized that the surgeon must be cautioned of the possibility of primary papillary carcinoma in the branchial cleft cyst.

Differential sensitivity to platinum-based chemotherapy in primary uterine serous papillary carcinoma cell lines with high vs low HER-2/neu expression in vitro

Differential sensitivity to platinum-based chemotherapy in primary uterine serous papillary carcinoma cell lines with high vs low HER-2/neu expression in vitro

Tracheal Squamous Cell Carcinoma Treated Endoscopically

Malignant primary tracheal tumors are extremely rare. The most common malignant primary tracheal tumors are squamous cell carcinoma and adenoid cystic carcinomas. In this brief report, we describe a patient who presented with a primary papillary squamous cell carcinoma in-situ at multiple areas in the trachea with a significant airway obstruction. Our case was successfully managed using a combination of electrocautery and argon photocoagulation for endotracheal ablation of the tumor and adjuvant external beam radiotherapy.

Abstract 2029: Identification of novel tumor suppressor microRNAs implicated in epithelial ovarian cancer from the 19q13.41 non-coding RNA cluster

Abstract Background: Epithelial ovarian cancer is the 5th leading cause of cancer death in women. Our objective was to identify key genetic events important for the pathogenesis of this lethal disease. Methods: Levels of microRNA (miRNA) expression were examined in specimens of primary papillary serous carcinomas, normal ovary and distal fallopian tube using Next Generation Sequencing and a custom expression array. Chromosomal gains and losses were also examined by CGH. SYBR Green reagents were used to measure relative expression of target gene expression by quantitative real-time PCR. Functional impact of altered miRNA expression was tested using standard MTT and Caspase 3/7 assays to measure proliferation and apoptosis (Promega). Key outcome demographics were coded and correlated with miRNA and gene expression by Kaplan-Meier analysis. Results: A total of 140 miRNAs were differentially expressed when papillary serous ovarian cancers were compared to either fimbrae of normal fallopian or normal ovary. Of these, 36 miRNAs were found to correlate with either overall survival, disease free interval (DFI) or platinum sensitivity. Nineteen (19) of these clinically significant miRNAs mapped to single primate-specific genomic locus located at 19q13.41. This locus spanned 125 Kb of non-coding DNA and encoded a total of 44 miRNAs, most all of which showed significant copy number variation in papillary serous ovarian cancers (n = 178) and showed copy losses in the majority of tumors. Using established algorithms for target prediction, we found that this miRNA cluster collectively targeted more than 2800 distinct genes. Key loci included gene products implicated in the epithelial-to-mesenchymal transition (Snail, Slug) as well as both the G1-S and G2-M cell cycle checkpoints (MYCN and Wee1). Transfection of established ovarian cancer cell lines with individual 19q13.41 miRNAs significantly reduced expression of Snail, Slug, Wee1, resulting in altered proliferation and apoptosis. Conclusions: Altered expression of 19q13.41 cluster miRNAs correlate with significant clinical outcomes for women with papillary serous ovarian cancers. These miRNAs appear to play a key role in regulating the expression of gene products critical for the ongoing proliferation and metastasis of ovarian cancer. Future work will focus on dissecting the role of individual 19q13.41 miRNAs in ovarian and other cancers as well as validating the novel nanoparticle-based strategies we have developed for therapeutic miRNA delivery. Supported by NIH TCGA and the Ovarian Cancer Research Foundation (OCRF) Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 2029.

Abstract 699: Uterine serous papillary carcinomas overexpress human trophoblast-cell-surface marker (Trop-2) and are highly sensitive to immunotherapy with hRS7, a humanized monoclonal anti-Trop-2 antibody

Abstract Purpose: To evaluate the expression of human trophoblast cell-surface marker (Trop-2) and the potential of hRS7, a humanized monoclonal anti-Trop-2 antibody, as a novel therapeutic strategy against Uterine Serous Papillary Carcinoma (USPC), a biologically aggressive and chemotherapy resistant variant of endometrial cancer. Methods: Trop-2 expression was evaluated by real time-PCR and flow cytometry in six primary uterine serous papillary carcinoma cell lines recently characterized in our laboratory. Sensitivity to hRS7 antibody-dependent-cellular-cytotoxicity (ADCC) was tested in standard 5-hrs 51Cr release-assays against primary USPC cell lines expressing different levels of Trop-2. Finally, to investigate the effect of interleukin-2 (IL-2) on hRS7-mediated ADCC, 5-hrs 51Cr assays were also conducted in the presence of low doses of IL-2 (i.e., 50-100 IU/ml). Results: Trop-2 mRNA transcript was significantly overexpressed in 3 out of 6 USPC primary cell lines when compared to normal human endometrial-cells (NEC) [p=0.005]. Consistent with RT-PCR data, high surface expression of Trop-2 was detected by flow cytometry in Trop-2 overexpressing cell lines [i.e., percentage of positive cells = 100% in all 3 positive cell lines, median (minimum-maximum) MFI (mean fluorescence intensity) of 184.2 (62.5-276.2)]. Importantly, while these USPC cell lines were found highly resistant to natural killer dependent cytotoxicity in the absence of the hRS7 antibody (range of killing 1.1% to 12.4%), they showed high sensitivity to hRS7-mediated ADCC in vitro (range of killing 28.2% to 64.4%) (P< 0.001). Incubation with IL-2 in addition to hRS7 further increased the cytotoxic activity against USPC cell lines overexpressing Trop-2 (p= 0.01). Conclusion: Primary USPC cell lines may overexpress Trop-2 at mRNA and protein level and are highly sensitive to hRS7-mediated cytotoxicity in vitro. hRS7 may represent a novel, potentially highly effective therapeutic strategy in patients harbouring advanced, recurrent or metastatic USPC refractory to standard treatment modalities. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 699.

Primary papillary thyroid carcinoma previously treated incompletely with radiofrequency ablation

Radiofrequency ablation (RFA) recently has been applied to benign thyroid nodules, mainly for the cosmetic reasons, and limited cases of local recurrences or focal distant metastases of well-differentiated thyroid cancer, in the high-risk reoperative condition or for the palliative purpose. But no report has been made on the RFA for primary thyroid cancer to date. We report on a patient with primary papillary carcinoma of thyroid gland who had undergone RFA before the cytological diagnosis of malignancy, later referred and treated with robotic surgery successfully. We can learn the following lessons from our case; (1) the RFA for operable primary thyroid malignancy should be avoided, because of the possibility of remnant viable cancer and undetectable nodal metastasis, and (2) robotic or endoscopic thyroid surgery may be a feasible operative method for benign or malignant thyroid nodules previously treated with RFA.

術前に大腸原発腫瘍が疑われた腹膜原発漿液性乳頭状癌の１例

背景 : 腹膜原発漿液性乳頭状癌 (primary serous papillary carcinoma of the peritoneum : PSCP) は組織学的に卵巣の漿液性乳頭状腺癌に類似する腹膜原発腫瘍である.今回, 術前に大腸粘膜下腫瘍が疑われた PSCP の 1 例を術中腹水および捺印細胞診で経験したので報告する.症例 : 78 歳, 女性. 腹部膨満感を主訴に来院. 精査にて下行結腸の狭窄を伴った粘膜下腫瘍と肝内に腫瘤を認め, 狭窄をきたした大腸粘膜下腫瘍に対して低位前方切除術を施行した. 開腹所見にて粘膜下腫瘤の子宮および卵巣への直接浸潤を認め, 子宮付属器が追加切除された. 術中腹腔洗浄細胞診および腫瘍捺印細胞診において, 腫瘍細胞は乳頭状集塊を形成し, 砂粒体を伴っていた. 摘出された大腸の肉眼像は大腸の漿膜から粘膜下にかけての腫瘤が主病変で, 両側卵巣は正常大であった. 大腸粘膜下の腫瘤は組織学的に卵巣の漿液性乳頭状腺癌に類似しており両側卵巣は正常大であったことから PSCP と診断した.結論 : 臨床的に明らかな卵巣腫大を認めず腹水細胞診において漿液性乳頭状腺癌に類似した細胞所見がみられた場合は, PSCP も念頭に置き診断すべきである.

Critical appraisal of FNAC in the diagnosis of primary papillary carcinoma arising in thyroglossal cyst: A case report with review of the literature on FNAC and its diagnostic pitfalls

The incidence of primary papillary carcinoma arising in thyroglossal cyst is rare and occurs in <1% of thyroglossal cysts. Even rarer is its diagnosis by pre-operative fine needle aspiration cytology (FNAC). Only 15 such cases diagnosed by FNAC have been previously reported in the literature. In this article, cytomorphology of the current case is presented along with a review of the literature on FNAC and its diagnostic pitfalls.

Papillary carcinoma in a supra hyoid thyroglossal duct cyst — an unusual presentation

Carcinomatous transformation of ectopic thyroid elements within the thyroglossal tract is a rare entity. We report a case of primary papillary carcinoma of thyroid presenting within the thyroglossal duct cyst in a 23 year old gentleman. The patient presented to us, as a case of suprahyoid thyroglossal cyst with sub-lingual involvement and he underwent surgical excision of the entire thyroglossal tract by Sistrunk's approach. The post-operative histopathological diagnosis was of a papillary carcinoma within the thyroglossal duct cyst. Hence, the patient was evaluated for a malignant focus in the thyroid which proved negative. He was counseled regarding the possibility of developing Carcinoma in the thyroid gland and offered two options of further management viz., total thyroidectomy followed by life long thyroid suppression or watchful observation and follow up. As the patient belonged to the low risk group, he opted for the second option. He is presently kept under meticulous follow up and remains asymptomatic till date. We present the pre- and post-operative imaging, intra-operative findings, histo-pathological features and review the present world literature on this rare entity.

Coexistence of tuberculous peritonitis and primary papillary serous carcinoma of the peritoneum: A case report and review of the literature

A major diagnostic challenge to the evaluation of an incomplete intestinal obstruction is to distinguish between infectious and malignant etiologies. We present a case of an elderly woman complaining of abdominal pain accompanied with nausea and vomiting, and failure to pass gas or stools. Anti-tuberculosis drugs were used to relieve her abdominal pain, and a needle biopsy of the peritoneal cavity showed evidence of primary papillary serous carcinoma of the peritoneum (PSCP). This is a rare description of tuberculosis in the setting of PSCP. This report illustrates the potential complex nature of malignancies, and emphasizes the need to consider coexistence of malignancy and infection in patients, especially in those with risk factors for malignancy who fail with antibiotic therapy.

Endobronchial Metastasis from Primary Papillary Serous Carcinoma of the Peritoneum

A 59-year-old woman was admitted to our hospital with a left lower lobe opacity and mediastinal shift on the chest X-ray. She had been complaining of intermittent nonproductive cough and exertional dyspnea. Chest computed tomography (CT) showed an endobronchial tumor of the left main to the lower bronchus, atelectasis of the left lower lobe, and mediastinal shift. Bronchoscopy revealed a polypoid tumor at the distal portion of the left main bronchus that occluded the bronchus. Biopsy specimens from the endobronchial tumor were shown to be serous papillary adenocarcinoma. Since the patient had been treated surgically for primary papillary serous carcinoma of the peritoneum (PSCP) 10 years earlier, immunohistochemical examinations were performed. The diagnosis of endobronchial metastasis of PSCP was confirmed by immunohistochemical staining with cancer antigen 125 (CA125), vimentin, and Wilms tumor-1 (WT-1). This is a rare case of endobronchial metastasis from PSCP.

Outcome of primary papillary carcinoma of thyroglossal duct cyst with local infiltration to soft tissues and uninvolved thyroid

Outcome of primary papillary carcinoma of thyroglossal duct cyst with local infiltration to soft tissues and uninvolved thyroid

Double primary bronchogenic carcinoma of the lung and papillary thyroid carcinoma: a case report

IntroductionDouble primary bronchogenic carcinoma and papillary carcinoma of the thyroid are extremely rare. We describe the case of a patient who underwent surgical resection for these two cancers.Case presentationA 56-year-old man presented to our hospital complaining of a cough with blood-tinged sputum. A slowly growing mass in the left lobe of the lung had been noted for about 1 year. He underwent video-assisted thoracic surgery of the left lower lobe and mediastinal lymph node dissection through an 8 cm utility incision. Pathology revealed a well-differentiated adenocarcinoma and the dissected lymph nodes were negative for malignancy. He also complained of a mass in his neck, which had grown slowly for over 5 years. A computed tomography scan of the neck revealed a left thyroid mass compressing the trachea towards the right side. There was no cervical lymphadenopathy. A left thyroid lobectomy was performed and pathology revealed a papillary carcinoma. Thus, he underwent a second operation to remove the right lobe of the thyroid. He underwent subsequent adjuvant chemotherapy.ConclusionIn a review of the literature, it appears that there has only been one previously reported case of these two cancers, which was in Japan. The relationship between these two cancers is still unclear, and more case reports are required to determine this relationship.

Primary papillary serous carcinoma of the peritoneum diagnosed by video-assisted thoracoscopic surgery: Report of a case

A 53-year-old woman who had end-stage renal disease and hypertension presented with back pain. Chest radiographs and chest computed tomography (CT) showed right pleural effusion with bilateral pleural masses. The patient underwent video-assisted thoracoscopic surgery (VATS) for a biopsy of the right pleural mass and for an evaluation of pleural effusion. A frozen section specimen suggested a papillary adenocarcinoma, which was confirmed to be metastatic primary papillary serous carcinoma of the peritoneum by immunohistochemistry, an elevated serum cancer antigen (CA-125) level, and abdominal CT findings. We found that the patient had been unfortunately misdiagnosed to have advanced colon cancer 11 years previously and thus had undergone a right hemicolectomy which was followed by six cycles of 5-fluorouracil chemotherapy. Despite this, she survived more than 10 years and was later correctly diagnosed by VATS of the pleural lesions and based on a review of the previous pathology. The patient was transferred to an oncologist to receive the proper chemotherapy with paclitaxel and carboplatin.

Primary Papillary Carcinoma of a Thyroglossal Duct Cyst

The incidence of papillary carcinoma arising in a thyroglossal duct cyst (TDC) is rare and occurs in about 1% of TDCs. Slightly more than 100 cases have been reported in the English literature. In most cases, the diagnosis is only established after excision of a clinically benign TDC. We report a case of papillary carcinoma arising in a TDC, presenting with an anterior neck mass in a 70-year-old man, who underwent a Sistrunk procedure for removal of the mass and an adherent lymph node. A second, more extensive operation was indicated based on pathologic findings after the initial dissection. Based on the histopathologic findings, the patient received postoperative I 131 ablation treatment (120 mCi). After 2 years, there was no evidence of disease recurrence. This type of carcinoma usually has a good prognosis, with only rare instances of metastasis, and can be successfully managed with surgery and careful follow-up.

Peritoneal disseminated recurrence and lung metastasis after surgery for stage IA uterine papillary serous carcinoma of the endometrium: a case report

We describe a case of synchronous peritoneal dissemination and multiple lung metastases after surgery for stage IA primary uterine papillary serous carcinoma (UPSC) of the endometrium, revealed by an uncontrollable retention of ascites. She was initially treated with a hysterectomy, bilateral salpingo-oophorectomy and pelvic lymphadenectomy after initial presentation. Tumor recurrence, diagnosed 12 months later, has been treated with six cycles of Paclitaxel 175 mg/m(2) and Carboplatin [area under the curve 5 (Calvert Formula)] every 3 weeks and showed an advantage of this regimen. Early recurrences of the stage IA UPSC can occur and continued close surveillance is recommended. We report herein the case about this entity.

A Case of Primary Papillary Carcinoma of Unknown Origin

近年，頭頸部外科領域では，頸部エコーなどの医療器機の進歩にともない，直径1cm以下の微小甲状腺癌が発見される機会が増加した。しかしながら，その治療方針に関しては，いまだ一定した見解を得ないのが現状である。今回，われわれは診断に苦慮した原発不明頸部乳頭癌の1例を経験したので，甲状腺微小癌の取り扱いについての若干の文献的考察を加え報告する。

Primary serous papillary carcinoma of the retroperitoneum: magnetic resonance imaging findings with pathologic correlation

The incidence of a primary serous papillary carcinoma of the retroperitoneum is extremely rare. We present a case of the tumour in an adult simulating an adrenal mass with MRI findings and histopathological correlation.

A diagnostic dilemma following risk-reducing surgery for BRCA1 mutation – a case report of primary papillary serous carcinoma presenting as sigmoid cancer

BackgroundWomen that carry germ-line mutations for BRCA1 or BRCA2 genes are at an increased risk of developing breast, ovarian and peritoneal cancer. Primary peritoneal carcinoma is a rare tumour histologically identical to papillary serous ovarian carcinoma. Risk-reducing surgery in the form of mastectomy and oophorectomy in premenopausal women has been recommended to prevent breast and ovarian cancer occurrence and decrease the risk of developing primary peritoneal cancer.Case presentationWe present a case report of a woman with a strong family history of breast cancer who underwent risk-reducing surgery in the form of bilateral salpingo-oophorectomy following a mastectomy for a right-sided breast tumour. Following the finding of a BRCA1 mutation, a prophylactic left-sided mastectomy was performed. After remaining well for twenty-seven years, she presented with rectal bleeding and altered bowel habit, and was found to have a secondary cancer of the sigmoid colon. She was finally diagnosed with primary papillary serous carcinoma of the peritoneum (PSCP).ConclusionPSCP can present many years after risk-reducing surgery and be difficult to detect. Surveillance remains the best course of management for patients with known BRCA mutations.

A rare case of incidentally diagnosed primary papillary carcinoma of thyroglossal duct cyst

Thyroglossal duct cysts are the most common congenital abnormality of thyroid development. Seventy percent of thyroglossal duct cysts are diagnosed during childhood and 7% are diagnosed in adulthood. Less than 1% of these cases are malignant with most being papillary in nature. It is often diagnosed incidentally after surgical excision. Incidentally discovered, well-differentiated thyroid carcinoma of the thyroglossal duct, in the presence of a clinically and radiologically normal thyroid gland, can be managed adequately by the Sistrunk operation. We present a rare case of primary papillary carcinoma of thyroglossal duct cyst, with normal thyroid gland, in a 28-year-old female that was diagnosed incidentally on histopathological examination. A Sistrunk procedure was performed on the patient to remove the thyroglossal duct cyst and patient is doing well at regular follow up.