Papillary and medullary thyroid carcinomas coexisting in the same lobe, first suspected based on fine-needle aspiration cytology: a case report
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Because different types of thyroid malignancies have distinct embryological origins, coexisting tumors are rarely observed. We describe a coexisting papillary thyroid carcinoma (PTC) and medullary thyroid carcinoma (MTC) first suspected by fine-needle aspiration cytology (FNAC). A 57-year-old female presented with an irregular mass in the right thyroid lobe. The cytopathologic findings of fine-needle aspiration showed two components: a papillary-like arrangement consisting of cells with pale enlarged nuclei indicative of PTC and loose clusters comprised of oval cells with granular chromatin indicative of MTC. The diagnosis of a coexisting PTC and MTC was initially confirmed by calcitonin immunocytochemistry and later after total thyroidectomy. Although some surgical case reports of PTC and MTC coexisting in either the same or different lobes have been documented, a case suspected by FNAC before the surgery has rarely been reported. Because appropriate treatment and prognosis of PTC and MTC are different, cytopathologists should be aware of this rare entity.
Abstract
Because different types of thyroid malignancies have distinct embryological origins, coexisting tumors are rarely observed. We describe a coexisting papillary thyroid carcinoma (PTC) and medullary thyroid carcinoma (MTC) first suspected by fine-needle aspiration cytology (FNAC). A 57-year-old female presented with an irregular mass in the right thyroid lobe. The cytopathologic findings of fine-needle aspiration showed two components: a papillary-like arrangement consisting of cells with pale enlarged nuclei indicative of PTC and loose clusters comprised of oval cells with granular chromatin indicative of MTC. The diagnosis of a coexisting PTC and MTC was initially confirmed by calcitonin immunocytochemistry and later after total thyroidectomy. Although some surgical case reports of PTC and MTC coexisting in either the same or different lobes have been documented, a case suspected by FNAC before the surgery has rarely been reported. Because appropriate treatment and prognosis of PTC and MTC are different, cytopathologists should be aware of this rare entity.
참고문헌 (27)
- Kazaure HS, "Aggressive variants of papillary thyroid cancer : incidence, characteristics and predictors of survival among 43, 738 patients", Ann Surg Oncol, 19, pp.1874~1880 (2012)
- Sadat Alavi M, "Medullary and papillary carcinoma of the thyroid gland occurring as a collision tumor with lymph node metastasis : a case report", J Med Case Rep, 5, pp.590~ (2011)
- De Felice M, "Thyroid development and its disorders : genetics and molecular mechanisms", Endocr Rev, 25, pp.722~746 (2004)
- Baloch ZW, "Special types of thyroid carcinoma", Histopathology, 72, pp.40~52 (2018)
- Kimura ET, "High prevalence of BRAF mutations in thyroid cancer : genetic evidence for constitutive activation of the RET", PTC-RAS-BRAF signaling pathway in papillary thyroid carcinoma, 2003, pp.63, 1454~1457
- Marsh DJ, "Somatic mutations in the RET proto-oncogene in sporadic medullary thyroid carcinoma", Clin Endocrinol(Oxf), 44, pp.249~257 (1996)
- Alberti L, "RET and NTRK1 proto-oncogenes in human diseases", J Cell Physiol, 195, pp.168~186 (2003)
- Greco C, "Concomitant medullary thyroid carcinoma with paragangliomalike pattern and papillary thyroid carcinoma", Endocrinol Diabetes Metab Case Rep, 2019, pp.19~0094 (2019)
- Kim WG, "Concurrent occurrence of medullary thyroid carcinoma and papillary thyroid carcinoma in the same thyroid should be considered as coincidental", Clin Endocrinol(Oxf), 72, pp.256~263 (2010)
- Maitra A, "Robbins and Cotran pathologic basis of disease", pp.1073~1140 (2015), Elsevier publications
- Braverman LE, "Werner and Ingbar’s the thyroid : a fundamental and clinical text" (2005), Lippincott Williams and Wilkins
- Wells SA Jr, "Revised American Thyroid Association guidelines for the management of medullary thyroid carcinoma", Thyroid, 25, pp.567~610 (2015)
- Jimenez C, "Management of medullary thyroid carcinoma", Endocrinol Metab Clin North Am, 37, pp.481~496 (2008)
- Rossi S, "Medullary and papillary carcinoma of the thyroid gland occurring as a collision tumour : report of three cases with molecular analysis and review of the literature", Endocr Relat Cancer, 12, pp.281~289 (2005)
- Sizemore GW, "Medullary carcinoma of the thyroid gland", Semin Oncol, 14, pp.306~314 (1987)
- Lloyd RV, "WHO classification of tumours of endocrine organs" (2017), IARC Press
- Lamberg BA, "Concurrent medullary and papillary thyroid carcinoma in the same thyroid lobe and in siblings", Acta Med Scand, 209, pp.421~424 (1981)
- Younes N, "Simultaneous medullary and papillary thyroid carcinoma with lymph node metastasis in the same patient : case report and review of the literature", Asian J Surg, 28, pp.223~226 (2005)
- 안동빈, "A Case of Concurrent Papillary and Medullary Thyroid Carcinomas Detected as Recurrent Medullary Carcinoma after Initial Surgery for Papillary Carcinoma", International Journal of Thyroidology, 6(1), pp.80~84 (2013), 대한갑상선학회
- Ali SZ, "The Bethesda System for Reporting Thyroid Cytopathology:definitions, criteria and explanatory notes" (2010), Springer
- Tuttle M, "AJCC cancer staging manual", pp.881~898 (2017), Springer International Publishing
- Cibas ES, "The 2017 Bethesda System for Reporting Thyroid Cytopathology", J Am Soc Cytopathol, 6, pp.217~222 (2017)
- Green I, "A spectrum of cytomorphologic variations in medullary thyroid carcinoma : fine-needle aspiration findings in 19 cases", Cancer, 81, pp.40~44 (1997)
- Trimboli P, "Detection rate of FNA cytology in medullary thyroid carcinoma : a meta-analysis", Clin Endocrinol(Oxf), 82, pp.280~285 (2015)
- Liu CY, "Constitutive cytomorphologic features of medullary thyroid carcinoma using different staining methods", Diagnostics(Basel), 11, pp.1396~ (2021)
- Papaparaskeva K, "Cytologic diagnosis of medullary carcinoma of the thyroid gland", Diagn Cytopathol, 22, pp.351~358 (2000)
- Biscolla RP, "Medullary and papillary tumors are frequently associated in the same thyroid gland without evidence of reciprocal influence in their biologic behavior", Thyroid, 14, pp.946~952 (2004)