Variant Of Anaplastic Thyroid Carcinoma Research Articles

Osteoclastic variant of anaplastic thyroid carcinoma: An insight into a rarest of rare entity.

Anaplastic thyroid carcinoma is a rare and a very aggressive thyroid malignancy with a dismal prognosis. It has a short history and presents with a rapidly increasing neck mass associated with compressive symptoms like pain, hoarseness of voice, dysphagia and shortness of breath. Osteoclastic variant is an extremely rare variant, which is, characterize by presence of a large number of multinucleated giant cells, which resemble osteoclasts. Here we report two cases of this unusual variant in a 68 years old and 49 years old male with a short history of thyroid swelling.

Cytodiagnosis of anaplastic thyroid carcinoma with osteoclast-like giant cells − A case report with a review of the literature

Anaplastic thyroid carcinoma (ATC) accounts for 5%–10% of primary thyroid malignancies. Cytodiagnosis of osteoclast-like giant cells (OLGCs) variant of ATC is very rare with only few cases reported in literature. We report a case of ATC with OLGC variant in an 85-year-old female who presented with swelling in the right lobe of thyroid and scalp nodule, which on radiological evaluation and subsequent fine-needle aspiration biopsy (FNAB) was diagnosed as ATC having numerous OLGC with metastases in skull bones. Cytologically, thyroid aspirate revealed sheets of epithelioid neoplastic cells admixed with many OLGC. Aspirate from the scalp nodule showed neoplastic cells with follicular differentiation. She also had radiological evidence of lung metastasis. Such a presentation of this rare variant being diagnosed by FNAB is rarely reported in literature and highlights the importance of this simple procedure in diagnosing and planning management of this rare condition.

CLINICOPATHOLOGICAL CHARACTERISTICS OF MUCINOUS VARIANT OF ANAPLASTIC THYROID CARCINOMA.

CLINICOPATHOLOGICAL CHARACTERISTICS OF MUCINOUS VARIANT OF ANAPLASTIC THYROID CARCINOMA.

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.

Paucicellular variant of anaplastic thyroid carcinoma: A diagnostic pitfall in thyroid pathology

Paucicellular variant is a rare variant of anaplastic carcinoma. Anaplastic thyroid carcinomas usually creates no problems in histologic diagnosis because of the obvious invasive growth, high cellularity, and marked degree of anaplasia, but paucicellular variant of anaplastic carcinoma is problematic in diagnosis because of its histologic mimicry to benign lesions, e.g. Riedel disease and fibrous variant of Hashimoto thyroiditis, i.e. prominent fibrosis and low cellularity. It is important to distinguish it from these two lesions because both are reactive conditions with favorable prognosis while anaplastic carcinoma is a malignant condition with poor prognosis. We present a case of 45-year-old female presented with a history of thyroid swelling for 10 years. The cytological diagnosis was given as colloid goiter while histopathological examination turned out to be paucicellular variant of anaplastic carcinoma thyroid. To conclude paucicellular variant is the entity to which all pathologists should be familiar and should know differential diagnosis while dealing with any fibrosed lesion of the thyroid.

Aspiration Cytology of the Osteoclastic Variant of Anaplastic Thyroid Carcinoma: with Special Emphasis on the Undifferentiated Mononuclear Cells

Anaplastic thyroid carcinoma (ATC) is an uncommon aggressive malignant tumor, and the osteoclastic variant of ATC is extremely rare. We report here on the fine needle aspiration cytology of the osteoclastic variant of ATC in an 83-year-old woman. The smear was composed of many oval to slightly elongated undifferentiated mononuclear cells admixed with multinucleated osteoclast-like giant cells. The mononuclear tumor cells revealed inconspicuous nuclear pleomorphism and the nuclei were characterized by vesicular chromatin and an indented or lobulated nuclear membrane with conspicuous nuclear grooves. A few epithelial clusters suggestive of a papillary carcinoma component were also observed. Making the proper cytological diagnosis of the osteoclastic variant of ATC is helpful to determine the proper treatment modality for these patients.

Inflammatory Pseudotumor of the Thyroid Gland Showing Prominent Fibrohistiocytic Proliferation. A Case Report

Inflammatory pseudotumor of the thyroid gland (IPT) appears to be exceedingly rare. Histologically, 14 previously reported cases demonstrated plasma cell granuloma variant. We report here an IPT showing a predominantly fibrohistiocytic proliferation that occurred in a 75-year-old Japanese woman. Histologically, the lesion was characterized by haphazardly arranged spindle cells, histiocytes having foamy cytoplasm containing intracytoplasmic brown pigments, and small lymphocytes. Immunohistochemical study demonstrated that the spindle cells were vimentin+, desmin-, muscle-specific actin+, cytokeratin-, endomysial antibody-, anaplastic lymphoma kinase-, CD34-- CD68+/-, CD99-, cyclin D1-, bcl-2-, and antifollicular dendritic cell antibody-. IPT showing a predominant fibrohistiocytic proliferation should be differentiated from various nonneoplastic or neoplastic disorders showing spindle cell proliferation and/or exuberant fibrosis. They include Riedel's thyroiditis, fibrous variant of chronic thyroiditis, papillary carcinoma with exuberant nodular fasciitis-like stroma, paucicellular variant of anaplastic thyroid carcinoma, and solitary fibrous tumor.

Rhabdoid Tumor of the Thyroid Gland: A Variant of Anaplastic Carcinoma

Rhabdoid tumor of the thyroid gland is a very rare neoplasm, characterized by significant metastatic potential. All of the 6 cases reported in the recent literature had poor outcomes. We report an additional case involving, to our knowledge, the oldest patient reported so far. A 67-year-old woman had a nodular goiter for all of her adult life and presented with a rapidly growing mass in the right lobe. Histologic examination showed a highly cellular neoplasm with a solid infiltrative growth pattern. Extracapsular invasion was evident. Rhabdoid cells were large, with abundant cytoplasm, eosinophilic inclusions, and eccentric nuclei containing distinct nucleoli. Immunohistochemistry identified vimentin, sarcomeric actin, myoglobin, and cytokeratin expression in the tumor cells; they were negative for desmin, thyroglobulin, and calcitonin. Scattered follicles with nuclear features of papillary thyroid carcinoma were detected; these cells were immunoreactive for thyroglobulin and TTF-1. Reverse transcriptase polymerase chain reaction using specific primers for RET/PTC1 and RET/PTC3 fusion genes identified a RET/PTC3 gene rearrangement in the rhabdoid tumor. Despite radiotherapy, the neoplasm rapidly progressed, with massive local and mediastinal metastasis leading to death 5 months after presentation. The hypothesis that rhabdoid tumor is a variant of anaplastic thyroid carcinoma is supported by the identification of a RET/PTC gene rearrangement, a feature of carcinomas of follicular cell derivation.

Early Diagnosis and Treatment of Medullary Thyroid Carcinoma

Medullary thyroid carcinoma (MTC) was first described as a distinct clinical entity by Hazard et al 1 in 1959. Although the lesion was previously thought to be a variant of anaplastic thyroid carcinoma, these investigators appreciated that certain histologic characteristics distinguished it from other thyroid neoplasms. Actually, MTC is derived not from follicular or stromal elements but from neural crest cells, which in mammals are incorporated within the thyroid gland. In birds and fish these cells exist as a separate structure called the ultimobranchial body. In retrospect, it is surprising that MTC was not recognized sooner as being different from other thyroid malignant neoplasms because it has certain unique characteristics, including frequent involvement of both thyroid lobes, occurrence in a familial pattern with assocated endocrinopathies (multiple endocrine neoplasia [MEN] types IIa and IIb), the presence in the tumor of a substance with the histochemical staining properties of amyloid, and the