A rare coexistence of papillary carcinoma and anaplastic carcinoma of thyroid in multinodular goitre: Case report and literature review

Shahi, Sudha; Bhandari, Tika Ram; Pantha, Tridip; Gautam, Dipendra

doi:10.1016/j.amsu.2020.06.024

Cited by 3 publications

(4 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Fine needle aspiration (FNA) usually diagnosed PTC or suspicious carcinoma. FNA cytology is thought to be of little diagnostic value in patients with MTC combined with PTC, as it is not easy to detect both pathological types of thyroid cancer (14)(15)(16)(17)(18)(19). The results of FNA in our center were similar to previous studies.…”

Section: Clinical Features and Diagnosissupporting

confidence: 80%

Thirty synchronous medullary and papillary thyroid carcinomas

et al. 2023

View full text Add to dashboard Cite

Synopsis for table of contentsAn exceptional number of synchronous MTC/PTC in the same thyroid gland is presented. This may be the most numerous case series reported in the literature. Synchronous PTC/MTC in the same thyroid gland were classified into 4 subtypes and the clinical and pathological aspects as well as the results are presented.Background and objectivesThe synchronous occurrence of multiple neoplastic processes in the thyroid gland is unusual. We investigated the clinicopathological features of 30 medullary thyroid carcinomas (MTC) in association with papillary (PTC).MethodRetrospective analysis of operated patients for thyroid tumors. Synchronous PTC/MTC in the same thyroid gland were classified into 4 subtypes: (type I) True mixed MTC/PTC, MTC and PTC closely intermingled. (Type II) Collision MTC/PTC, i.e. tumors that meet at the same site, invade each other and appear as a single mass in the thyroid gland, i.e. MTC and PTC merge. (Type III) Synchronous anatomically separate tumors in the same thyroid lobe, i.e. separated from each other by non-tumorous thyroid parenchyma. (Type IV) Synchronous tumors occurring in separate anatomical lobes or in the isthmus. Clinical and pathological data were reviewed. Location: Department of thyroid surgery, China-Japan Union Hospital, Jilin University. Time frame: 14 years (June 2008-November 2022).ResultsThirty patients were identified with an overall prevalence of 28621 (0.1%). 17 (56.7%) were male, 13 (43.3%) female, mean age 51.3 ± 11.0 years, mean BMI 23.6 ± 3.6kg/m2. Mean duration of symptoms was 11.2 ± 18.4 months. Mean calcitonin level was 133.7 ± 196.4 pg/ml. Fine needle aspiration (FNA) was offered in 21 cases: 9 (42.9%) were suspected carcinoma, 9 (42.9%) PTC, 1 (4.8%) MTC, 2 (9.4%) MTC/PTC. Pathology revealed type I 4 (13.3%), type II 2 (6.7%), type III 14 (46.7%), type IV 10 (33.3%). The mean diameter of MTC was 1.6 ± 2.0cm, 18 (60%) were micro-MTC. The mean diameter of PTC was 0.9 ± 1.9 cm, 26 (86.7%) were micro-PTC. In 16 (53.3%) micro-PTC/-MTC occurred in synchronous sequence. Four patients had a recurrence: 2 had to be re-operated due to MTC recurrence, 2 died due to distant metastases (bone, liver).ConclusionWe report an exceptional number of MTC/PTC in the same thyroid gland. This may be the most numerous case series reported in the literature. The clinical and pathological aspects as well as the results are presented.

show abstract

Section: Clinical Features and Diagnosissupporting

confidence: 80%

Thirty synchronous medullary and papillary thyroid carcinomas

et al. 2023

View full text Add to dashboard Cite

show abstract

“…In our study, 61 STC met the definition of thyroid collision tumor.Previous clinical reports on mixed thyroid carcinoma were mostly medullary-follicular carcinoma [11,17,18] .Mixed medullary and follicular cell-derived thyroid carcinoma(MMFTC) is a rare primary thyroid carcinoma composed of admixed parafollicular and follicular cell-derived tumor populations within a single lesion. MMFTC was recognized in the World Health Organization (WHO) Classification of Tumors of Endocrine Organs for the first time in 2004 and the current fourth edition classification (2017) reports <60 cases [11] .In addition, mixed papillary and follicular carcinoma(MPFTC),mixed squamous cell and follicular carcinoma ,mixed anaplastic carcinoma of the thyroid with papillary carcinoma (MAPTC)and Other types of mixed thyroid carcinoma are also occasionally reported [12,19,20] , we found 7 mixed thyroid carcinomas, including 3 MMTC, 1MAPTC, and 1 MPFTC, 1 mixed papillary and poorly differentiated thyroid carcinoma, 1 mixed papillary thyroid carcinoma and squamous cell carcinoma.…”

Section: Discussionmentioning

confidence: 99%

“…The results showed that the age of SDDTC was younger than that of SMDTC and SADTC, and the average age at diagnosis of SADTC was the largest, followed by SMDTCr, which was similar to the age analysis results of singleton thyroid cancer [31][32][33] .There was no statistically significant gender difference among the three groups，SADTC not only has a longer maximum tumor diameter than SDDTC and SMDTC, but also has a significantly longer disease duration than SDDTC and SMDTC, previously reported that anaplastic carcinoma is highly aggressive, progresses rapidly, and the neck mass expands rapidly [34] .However, the SADTC in our case has a longer course of disease, up to 20 years. There are existing reports on SADTC and the course of the disease are also more than 20 years [9,12] , may be due to undifferentiated progression from differentiated [35] .…”

Section: Discussionmentioning

confidence: 99%

“…Such reports have aroused extensive discussion, and since then, the coexistence of multiple different types of thyroid cancer has gradually been reported and recognized. To date, the cases of synchronous squamous cell carcinoma of thyroid(SCCT), papillary(PTC), follicular(FTC), medullary(MTC), poorly differentiated(PDTC) and anaplastic(ATC) thyroid carcinomas have been reported, and both coexisting forms of thyroid cancer have also been implicated [5,[8][9][10][11][12] . However, due to factors such as rare cases and limited conditions, there are few clinical studies on the clinicopathological characteristics and prognosis of multiple synchronous, distinct subtypes of primary thyroid carcinoma.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Clinicopathological features and prognostic factors analysis of multiple synchronous distinct subtypes of primary thyroid carcinoma

Dai

Ding

et al. 2022

Endocrine

View full text Add to dashboard Cite

Purpose: To investigate the clinicopathological features, diagnosis, treatment and prognosis of multiple synchronous distinct subtypes of primary thyroid carcinomas Methods: The clinical data of 68 cases of synchronous carcinomas of the thyroid(STC) admitted to the Department of Thyroid Surgery in our hospital from January 2013 to December 2021 were reviewed.，According to the pathological type, they were divided into the Synchronous differentiated and differentiated thyroid Carcinoma(SDDTC)group (42 cases), the Synchronous medullary and differentiated thyroid Carcinoma(SMDTC)group (18 cases), and the Synchronous Anaplastic and differentiated thyroid Carcinoma (SADTC)group (8 cases). The diagnosis, treatment and survival of patients in each group were analyzed.Results: Women with coexisting thyroid cancer were predominant (59 cases). Most of the symptoms were found on physical examination and neck mass. In the SDDTC group, the median age of patients in the SDDTC group, SADTC group and SMDTC group was 47.5 (28-74) years old, 68.5 (26-75) years old, and 56.5 (39-74) years old. The age of the SADTC group and SMDTC group was older than that of the SDDTC group (P=0.04, P=0.03), and lymph node metastasis was more likely to occur (P=0.02, P<0.01).The disease course time, tumor location, clinical stage, and mortality of the SADTC group were significantly different from those of the SDDTC group and SMDTC group (P<0.05). The overall survival of patients with synchronous carcinomas of the thyroid was 6-105 months, and the median overall survival was 38.5 months. The tumor-free survival was 0-90 months, 19.1% of patients developed distant metastasis, 11.8% of patients had postoperative recurrence, and the survival rate was 91.18%. Cox model multivariate analysis showed that cervical lateral lymph node metastasis and tumor stage III/IV were independent ris k factors for progression-free survival(PFS).The comparison results of the survival curves showed that the overall survival(OS)of the patients in the SADTC group was significantly worse (P<0.01), while there was no significant difference in the PFS of different pathological types (χ2=5.024, P=0.081).The OS of different treatment methods was significantly different (P=0.002), but there was no significant difference in OS between local recurrence and distant metastases with or without surgery (χ2=0.954, P=0.329). Conclusions:The STC has relatively unique clinical characteristics, and most patients can get a better prognosis after radical surgery. Pathological type, lateral cervical lymph node metastasis, tumor stage and treatment are important factors which affect the prognosis of the disease. Since there are two distinct tumors with different aggressiveness, treatment options and prognosis, individualized management is required.

show abstract

Clinicopathological features and prognostic factors analysis of multiple synchronous distinct subtypes of primary thyroid carcinoma

Dai

Ding

et al. 2022

Preprint

View full text Add to dashboard Cite

Purpose: To investigate the clinicopathological features, diagnosis, treatment and prognosis of multiple synchronous distinct subtypes of primary thyroid carcinomas Methods: The clinical data of 68 cases of synchronous carcinomas of the thyroid(STC) admitted to the Department of Thyroid Surgery in our hospital from January 2013 to December 2021 were reviewed.，According to the pathological type, they were divided into the Synchronous differentiated and differentiated thyroid Carcinoma(SDDTC)group (42 cases), the Synchronous medullary and differentiated thyroid Carcinoma(SMDTC)group (18 cases), and the Synchronous Anaplastic and differentiated thyroid Carcinoma (SADTC)group (8 cases). The diagnosis, treatment and survival of patients in each group were analyzed. Results: Women with coexisting thyroid cancer were predominant (59 cases). Most of the symptoms were found on physical examination and neck mass. In the SDDTC group, the median age of patients in the SDDTC group, SADTC group and SMDTC group was 47.5 (28-74) years old, 68.5 (26-75) years old, and 56.5 (39-74) years old. The age of the SADTC group and SMDTC group was older than that of the SDDTC group (P=0.04, P=0.03), and lymph node metastasis was more likely to occur (P=0.02, P<0.01).The disease course time, tumor location, clinical stage, and mortality of the SADTC group were significantly different from those of the SDDTC group and SMDTC survival was 38.5 months. The tumor-free survival was 0-90 months, 19.1% of patients developed distant metastasis, 11.8% of patients had postoperative recurrence, and the survival rate was 91.18%. Cox model multivariate analysis showed that cervical lateral lymph node metastasis and tumor stage III/IV were independent risk factors for progression-free survival(PFS).The comparison results of the survival curves showed that the overall survival(OS)of the patients in the SADTC group was significantly worse (P<0.01), while there was no significant difference in the PFS of different pathological types (χ2=5.024, P=0.081).The OS of different treatment methods was significantly different (P=0.002), but there was no significant difference in OS between local recurrence and distant metastases with or without surgery (χ2=0.954, P=0.329). Conclusions: The STC has relatively unique clinical characteristics, and most patients can get a better prognosis after radical surgery. Pathological type, lateral cervical lymph node metastasis, tumor stage and treatment are important factors which affect the prognosis of the disease. Since there are two distinct tumors with different aggressiveness, treatment options and prognosis, individualized management is required.

show abstract

A rare coexistence of papillary carcinoma and anaplastic carcinoma of thyroid in multinodular goitre: Case report and literature review

Cited by 3 publications

References 20 publications

Thirty synchronous medullary and papillary thyroid carcinomas

Thirty synchronous medullary and papillary thyroid carcinomas

Clinicopathological features and prognostic factors analysis of multiple synchronous distinct subtypes of primary thyroid carcinoma

Clinicopathological features and prognostic factors analysis of multiple synchronous distinct subtypes of primary thyroid carcinoma

Contact Info

Product

Resources

About