Primary Squamous Cell Carcinoma Of Thyroid Research Articles

739 A Primary Thyroid Squamous Cell Carcinoma Presenting as a Left-Sided Neck Lump

Abstract The elderly patient presenting with a neck lump often raises concerns regarding a malignany. Thyroid gland malignancies are well-recognised and sub-type characteristics thoroughly researched, whereas rarer types of thyroid carcinoma are reported infrequently and often behave more aggressively. An 83-year-old female was referred from the GP to ENT due to a 7-month history of an unexplained enlarging left-sided neck swelling. A fine needle aspiration revealed cytology consistent with squamous cell carcinoma (SCC). Staging imaging failed to reveal evidence of a primary foci elsewhere. The definitive diagnosis was that of a primary thyroid SCC: a rare entity with limited citations in the literature. Surgical resection has been found to comprise the optimal treatment for this disease. Recognition of the possibility of primary thyroid SCC in elderly patients presenting with a neck lump, with prompt referral to a head and neck specialist permits a timely progression to potentially curative surgical management, a more promising prognosis and reduced mortality rates.

Clinical analysis of 13 cases of primary squamous-cell thyroid carcinoma.

ObjectiveTo analyze the clinical features, ultrasonographic manifestations, pathological features, treatment and prognosis of primary thyroid squamous cell carcinoma (PSCTC) and summarize the experience in diagnosis and treatment of this condition.MethodsA retrospective analysis was conducted on patients who were admitted to Zhejiang Cancer Hospital from 2007 to 2021 due to thyroid nodules or thyroid malignant tumors that were ultimately confirmed by postoperative pathology as primary thyroid squamous cell carcinoma. We summarize the general situation, clinical information, laboratory examination, ultrasonic image characteristics, pathological examination, clinical treatment and prognosis of the patients.ResultsPSCTC is most often seen in older men and progresses rapidly. In laboratory tests, some patients had elevated levels of tumor markers (CA199, squamous cell carcinoma antigen level), thyroglobulin levels and tumor-related substances, but all these indicators lacked specificity. The ultrasound features of PSCTC are mainly hypoechoic, hard, substantial nodules with gross borders and a grade 1-2 blood flow signal, sometimes with signs of necrosis and calcification. In terms of treatment, PSCTC is mainly surgically resected, though some patients in this study underwent iodine-131 radiation therapy, local radiotherapy, and chemotherapy with unclear results. None of the patients survived for very long after treatment, but the prognosis of patients with highly differentiated squamous carcinoma was significantly better than that of patients with poorly differentiated squamous carcinoma. Papillary thyroid carcinoma may be one of the causes of PSCTC.ConclusionPSCTC is a malignant tumor with high malignancy and rapid clinical progression. Treatment options are mainly based on surgical resection and can be supplemented with radiotherapy and chemotherapy, but there is still a lack of a standardized treatment management system, and more cases and reports are needed to accumulate data.

Primary Thyroid Squamous Cell Carcinoma With Complete Response to Radical Surgery and Concurrent Chemoradiotherapy: Diagnostic Pathologic Workup and Clinical Management

Abstract Primary squamous cell carcinoma (SqCC) of the thyroid gland is an extremely rare, highly aggressive malignancy associated with locally advanced disease and frequent metastases to regional lymph nodes and distant sites. There are no standardized guidelines for treating primary thyroid SqCC because of its rarity, but some investigators have recommended staging and treating it as a variant of anaplastic thyroid carcinoma. Prognosis, however, remains poor with minimal response to treatment and an estimated median survival of 6 to 14 months. We report a case of primary SqCC of the thyroid that was successfully treated with aggressive locoregional resection followed by concurrent radical dose radiotherapy and cisplatin-based chemotherapy. The patient remains free of disease more than 4 years after surgery and adjuvant chemoradiation. Because of potential prognostic and management implications, it is crucial to make an accurate pathologic diagnosis of primary SqCC of the thyroid and distinguish it from metastatic squamous carcinoma and other primary thyroid malignancies with squamous features. A thorough clinicopathologic diagnostic workup including immunohistochemistry, computed tomography scan, and endoscopy is mandatory. In this case, treatment similar to the standard management used for patients with locally advanced mucosal head and neck squamous cancer led to a successful outcome.

249 Primary Thyroid Squamous Cell Carcinoma With Lung Metastasis

249 Primary Thyroid Squamous Cell Carcinoma With Lung Metastasis

Diagnostic significance of PAX8 in thyroid squamous cell carcinoma.

Most types of thyroid carcinomas express PAX8 transcription factor; however, whether thyroid squamous cell carcinoma (SCC) also expresses PAX8, currently remains unknown. We herein examined the immunoreactivity of PAX8 in SCC of thyroidal and extrathyroidal origin, and discussed the diagnostic significance of PAX8. We immunohistochemically examined specimens from 11 SCC, 22 papillary thyroid carcinoma (PTC), 8 anaplastic thyroid carcinoma (ATC), and 2 mucoepidermoid carcinoma (MEC) cases as well as 5 uterine cervical SCC, 5 esophageal SCC, and 5 pulmonary SCC cases. The rates of PAX8-positive SCC, PTC, ATC, and MEC were 90.9%, 90.9%, 75.0%, and 100%, respectively. Two PAX8-negative PTC cases were cribriform variants. No uterine cervical, esophageal, or pulmonary SCC specimen reacted with PAX8 antibody. Thyroid transcription factor-1 (TTF-1) was positive in 9.1% and 95.5% of SCC and PTC cases, respectively, but negative in all ATC and MEC cases. These results demonstrate that PAX8 staining is useful for distinguishing between primary thyroid SCC and invasion or metastasis from extrathyroidal SCC. We recommend using an immunohistochemical panel of antibodies to PAX8 and TTF-1 to confirm a diagnosis of primary thyroid carcinoma.

Squamous cell carcinoma of the thyroid gland: primary or secondary disease?

To review the aetiopathogenesis, clinical characteristics, immunohistochemical profile, prognosis and treatment options for primary thyroid squamous cell carcinoma, and to compare it with squamous cell carcinoma metastatic to the thyroid, thus providing the reader with a framework for differentiating primary and secondary disease. Review of English language literature from the past 25 years. A search of the Medline, Embase and Cochrane databases (April 1984 to April 2009) was undertaken to enable a comprehensive review. After applying strict criteria for the diagnosis of primary thyroid squamous cell carcinoma, 28 articles were identified reporting 84 cases. When reviewing secondary thyroid squamous cell carcinoma, we only analysed cases of squamous cell carcinoma metastatic to the thyroid gland, and found 28 articles reporting 78 cases. It is possible to differentiate between primary and secondary thyroid squamous cell carcinoma, on the basis of combined evidence from clinical examination and endoscopic, pathological and radiological evaluation. Such differentiation is important, as the prognosis for primary squamous cell carcinoma is uniformly poor irrespective of treatment, and the most suitable option may be supportive therapy. Treatment for secondary squamous cell carcinoma of the thyroid varies with the site and extent of spread of the primary tumour.

A Case of Primary Thyroid Squamous Cell Carcinoma Treated by Surgical Excision of the Upper Trachea

甲状腺原発扁平上皮癌は稀な疾患であり，その予後は非常に悪いことが知られている。今回2年以上再発なく経過良好であった甲状腺扁平上皮癌の1例を経験したので報告する。症例は68歳男性。前頸部腫瘤を自覚したため近医を受診した。腫瘤は数日で急激に増大し，軽度の呼吸困難感が出現した。CTにて甲状腺右葉に腫瘍を認め，細胞診で低分化型扁平上皮癌の診断を得た。当科紹介となり，発症から17日目に甲状腺全摘，右根治的頸部郭清術，上縦隔郭清術，気管環状切除および端々吻合による再建を行った。気管切除は9気管輪に及んだが，縫合不全や誤嚥などの合併症は見られなかった。その後化学療法，放射線照射を行い，術後2年4カ月再発なく経過良好である。発症早期に徹底した根治手術を行えたことが，予後良好であった一因と考えられた。また気管端々吻合による合併症予防を考慮した術後管理が重要であると考えられた。

Primary Squamous Cell Carcinoma of the Thyroid: Immunohistochemical Profile and Literature Review

Squamous cell carcinoma accounts for 1% of primary thyroid malignancies and is characterized by a rapidly unfavorable outcome. A 64-year-old woman presented with a painless mass in the left neck, coexisting with thyroid goiter. Total thyroidectomy with lymphadenectomy was performed and a primary thyroid squamous cell cancer was confirmed histologically after excluding any other possible primary malignancies. The tumor's immunohistochemical profile was explored using a large panel of antibodies. The tumor featured a positive immunoreaction to cytokeratins 7-19 and to squamous cell carcinoma antigen. Low-molecular-weight cytokeratins 5-6 and epithelial membrane antigen were also expressed. The neoplasm's proliferative index (Mib1) was 60%. No immunostaining was detected for cytokeratins 10-20, thyroglobulin, TTF-1, CD5, galectin-3 or p53. This case of primary thyroid squamous cell carcinoma immunohistochemically profiled using a large panel of immunoreactions may offer useful information on the histological differentiation of thyroid squamous cell carcinoma from other (uncommon) thyroid carcinomas and the distinction between primary and secondary thyroid cancers.