Carcinoma showing thymus-like element (CASTLE) of thyroid: Combined modality treatment in 3 patients with locally advanced disease

Chow, Sin‐Ming; Chan, J.K.C.; Tse, Loretta; Tang, Dong; Ho, Chiu M.; Law, Stephen C.K.

doi:10.1016/j.ejso.2006.09.016

Cited by 40 publications

(37 citation statements)

References 5 publications

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“…Data on recurrence were extracted from 13 case series identified for collective analysis (7,17,27,29,33,35,73,124,126,(135)(136)(137)(138)) and nine individual case reports (14,15,17,44,56,61,81,98,139) and are listed in Table S4. The disease-free interval ranged from 1 to 58 months.…”

Section: Assessment Of Recurrencementioning

confidence: 99%

“…There were 64 individual case reports and 96 case series (consisting of more than one case). Of the 96 case series, 17 series contained enough details to extract individual patient data; these 110 patients were analyzed with the individual case reports (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24). Forty-five case series reported exclusively on tracheal invasion by thyroid cancer (Table S1).…”

Section: Quantity Of Evidencementioning

confidence: 99%

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Secondary tracheal tumors: a systematic review

Madariaga¹,

Gaissert²

2018

Ann. Cardiothorac. Surg.

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Background: Secondary tracheal tumors arise from mural invasion by primary tumors in adjacent organs, metastatic lymph nodes or blood-born metastasis from distant sites. This systematic review aims to assess the presentation, management options, and clinical outcomes of these uncommon non-tracheal malignancies.Methods: Electronic searches of the MEDLINE database were performed to identify case series and individual case reports of tracheal invasion by primary non-tracheal tumors or metastatic disease. AllEnglish-language studies with available abstracts or articles containing primary data were included.Results: From 1978 to 2017, a total of 160 case reports or case series identified 2,242 patients with invasion of the trachea by tumors of adjacent organs (n=1,853) or by metastatic lymph nodes or hematogenous spread (n=389). Common primary sites of origin were thyroid, esophagus, and lung, and the most common presentation was metachronous (range of interval: 0 to 564 months) with dyspnea, neck mass, voice change and/or hemoptysis. A majority of patients in case reports (77.9%) and case series (66.0%) underwent resection and the most common reported operation was segmental tracheal resection. Fewer patients underwent bronchoscopic intervention (21.7%) and radiation was used in 32.2% of patients. Complications after bronchoscopic treatment included bleeding, granulation tissue, and retained secretions, while anastomotic leak, unplanned tracheostomy, and new recurrent laryngeal nerve paralysis were observed after surgical resection. The rate of 30-day mortality was low (0.01-1.80%). Median survival was higher in patients with thyroid malignancy and in patients who underwent surgical management. Follow-up time ranged from 0.03 to 183 months. Conclusions:Patients with tracheal invasion by metastatic or primary non-tracheal malignancies should be assessed for symptoms, tumor grade, tumor recurrence and concurrent metastases to decide on optimal surgical, bronchoscopic or noninterventional therapy. Clinical experience suggests that palliative endoscopic intervention for tracheal obstruction by metastasis-bearing lymph nodes is underreported.Keywords: Endotracheal metastasis; secondary tracheal tumors; systematic review Submitted Nov 24, 2017. Accepted for publication Dec 21, 2017Dec 21, . doi: 10.21037/acs.2018 View this article at: http://dx.doi.org/10.21037/acs.2018.02.01 Systematic Review IntroductionSecondary tracheal tumors are defined as tumors in, but not of the trachea and comprise a wide spectrum of tumor histologies and stages. There are no populationbased data for these tumors, and in clinical practice these lesions are probably more common than primary neoplasms. A thoracic surgeon probably encounters tracheal obstruction by metastatic lymph nodes more often than invasion by adjacent primary tumors. Since natural history and prognosis are related to the tumor of origin, their management and prognosis may differ considerably from primary tracheal neoplasms; a correct diagnosis with attribution to the origi...

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Section: Assessment Of Recurrencementioning

confidence: 99%

Section: Quantity Of Evidencementioning

confidence: 99%

Secondary tracheal tumors: a systematic review

Madariaga¹,

Gaissert²

2018

Ann. Cardiothorac. Surg.

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“…6,20 Some of the literature has reported that postoperative radiation could prevent locoregional recurrence. 1,5,9,21 In our study, 7 of 8 patients accepted postoperative radiation, and no locoregional recurrence occurred in 8 cases. For locoregional recurrence, Sun et al reported that recurrences may be controlled by salvage surgery with subsequent operation and/or radiotherapy.…”

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confidence: 97%

Clinical Analysis of Thyroid Carcinoma Showing Thymus-Like Differentiation: Report of 8 Cases

Liu

Teng

Sun

et al. 2013

International Surgery

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Thyroid carcinoma showing thymus-like differentiation (CASTLE) is a kind of rare neoplasm of the thyroid gland. Because thyroid CASTLE is rare and difficult to diagnose, its clinicopathologic features have not been well defined, and no universally accepted treatment recommendation is available. We analyzed retrospectively the clinicopathologic data of 8 patients with thyroid CASTLE who underwent surgery and radiotherapy at the Shengjing Hospital of China Medical University between December 2008 and June 2012. All patients accepted radical surgery. All patients accepted postoperative radiotherapy, except one 79-year-old patient. There was no evidence of recurrence or metastasis during the follow-up period. The pattern of immunohistochemical staining was similar to that of thymic carcinoma. Six of 8 CASTLE cases expressed CD5. All 8 CASTLE patients were negatively expressed in thyroglobulin, thyroid transcription factor 1, and calcitonin. Patients with thyroid CASTLE have good outcomes after radical resection and postoperative radiotherapy. Positive CD5 immunoreactivity can contribute to diagnosis of this disease.

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“…Although it grows slowly, metastasis to regional lymph nodes, invasion to adjacent structure and distant metastasis to other organs were informed. (1,2) and approximately half of the cases represented metastatic lymph nodes at initial finding. (6) Its clinical symptoms usually include painless neck mass or hoarseness; however, our case did not present any symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…CASTLE is an uncommon neoplasm. In medical literatures, less than 30 cases have been reported, (1,2) and in domestic research few cases were reported. (3,4) Furthermore, as far as we know, synchronous neoplasm with CASTLE has never been reported.…”

Section: Introductionmentioning

confidence: 99%

Synchronous Carcinoma Showing Thymus-like Elements (CASTLE) of the Thyroid Combined with Rectal Carcinoma: Report of a Case and Review of the Literature

Lee

Baek

et al. 2008

Korean J Endocr Surg

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Carcinoma showing thymus-like elements (CASTLE) is a rare neoplasm arising from the thyroid gland. This tumor is thought to originate from ectopic thymic tissue or remnants related to thymic development in or adjacent to the thyroid gland and usually located in the lower two-thirds of the thyroid gland. The patient was a 66-year-old man admitted to our hospital with rectal carcinoma for surgery. He had undergone a right upper lobectomy of the lung for the pulmonary tuberculosis 35 years previously. He underwent a chest computed tomography (CT) pre-operatively, and an incidental nodule of the thyroid gland was detected. Based on aspiration cytology of the nodule, the lesion was suspected to be an anaplastic carcinoma. He underwent a low anterior resection and thyroid lobectomy for a double primary neoplasm. On the final pathologic examination, the thyroid lesion was shown to be CASTLE. Therefore, completion thyroidectomy with lymph node dissection of the central compartment and radiotherapy were performed, and there was no evidence of recurrence 15 months postoperatively. (Korean J Endocrine Surg 2008;8:266-268)

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Carcinoma showing thymus-like element (CASTLE) of thyroid: Combined modality treatment in 3 patients with locally advanced disease

Cited by 40 publications

References 5 publications

Secondary tracheal tumors: a systematic review

Secondary tracheal tumors: a systematic review

Clinical Analysis of Thyroid Carcinoma Showing Thymus-Like Differentiation: Report of 8 Cases

Synchronous Carcinoma Showing Thymus-like Elements (CASTLE) of the Thyroid Combined with Rectal Carcinoma: Report of a Case and Review of the Literature

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