A mucin-producing carcinoma in the thyroid gland found in a 44-year-old man was first thought to be a metastatic carcinoma, possibly from salivary gland. However, follow-up examinations for 8 years have not demonstrated another neoplasm, and it seems reasonable to conclude that this lesion was a rare primary mucinous adenocarcinoma of the thyroid gland.Cancer 38:1323-1325, 1976.RIMARY MUCIN-PRODUCING ADENOCARCINOMA P of t h e thyroid gland is very rare, if not unreported, i n the literature. A review of the reports t h a t include large n u m b e r s of cases of thyroid carcinomas does not document its occurrence, and this may be t h e first report of such a n e o p l a~m .~,~-~.~The neoplasm was found in a 44-year-old m a n , w h o w a s first thought t o have a carcinoma metastatic to t h e thyroid gland. However, t h e patient h a s b e e n followed for 8 years without t h e development of recurrent neoplasm in the neck or the discovery of a primary carcinoma in ano t h e r organ.
CASE REPORTA 44-year-old man was seen at Seaway Hospital in Trenton, Michigan, for the first time in hlarch, 1967, with the chief complaint of a rapidly growing mass in the neck.Physical examination showed a visible, painless, and movable mass in the right side of the neck. There were no other abnormal physical findings nor any pertinent abnormalities in the review of systems.Roentgenograms of the chest and upper and lower gastrointestinal tracts were normal.A partial thyroidectomy was performed. The specimen consisted of an irregular, lobulated, myxomatous mass weighing 17 g and measuring 5 X 4 X 3 cm. The periphery of the myxomatous nodule consisted of a rim of thyroid gland, which showed the changes of a nonspecific chronic thyroiditis (Fig. 1). The myxomatous appearance of the nodule was caused by large amounts of mucinous material within it. The nodule was composed predominantly of mucinous material containing strands and clusters of small cells. The mucoid material stained positively with thr mucicarmine stain (Fig. 2). A few cells contained intracytoplasmic mucicarmine-positive material. In addition, there were solid areas with little mucinous material (Fig. 3).l h e slides were reviewed by several consultants and the histologic diagnoses varied from a primary mucin-producing adenocarcinoma to a metastatic carcinoma, most likely from salivary gland. T h e majority of the consultants favored a diagnosis of metastatic carcinoma.Because of the uncertain histologic diagnosis, a total thyroidectomy and a right radical neck dissection were performed. No neoplasm was found in the additional tissues.The patient has been examined yearly since his first operation. In 1974, the patient had a cholecystectomy and at that time a thorough examination of the abdominal viscera revealed no neoplasm.The last follow-up examination was done in March, 197.5, and the patient was in good health with no evidence of recurrent cancer.
DISCUSSIONO u r conclusion t h a t t h e lesion w e have described is a p r i m a r y thyroid carcinoma is based solely...