Composite Follicular Variant of Papillary Carcinoma and Mucoepidermoid Carcinoma of Thyroid Gland: A Case Report

Jung, Yong Han; Kang, Mi Seon

doi:10.3346/jkms.2010.25.11.1683

Cited by 17 publications

(12 citation statements)

References 17 publications

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“…Immunohistochemistry studies of MEC have shown changes to the cell adhesion complexes such as the new expression of P-cadherin in MEC compared to papillary tumours [3, 4, 7]. The cells that are frequently described as being present in MEC are squamous epithelial and mucinous cells which stain positive for Alcian blue stain [3–5]. Both these were identified in the histological samples of our case, justifying the diagnosis of MEC.…”

Section: Discussionsupporting

confidence: 63%

“…Although there have been reports of ~50 cases of primary mucoepidermoid carcinoma in literature, in a literature search involving EMBASE, MEDLINE and OVID 22 cases of mucoepidermoid occurring with concurrent papillary thyroid cancer were noted. But the presence of MEC with the ‘follicular variant’ of papillary cancer is even rarer with only two cases which has been described before [4, 5].…”

Section: Discussionmentioning

confidence: 99%

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Composite poorly differentiated mucoepidermoid carcinoma of the thyroid and follicular variant of papillary thyroid carcinoma. Report of a case and review of the literature

Jayakody

Faoury

Fraser

et al. 2019

Journal of Surgical Case Reports

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Mucoepidermoid variant of thyroid carcinoma is a rare and complex disease. Securing a diagnosis and formulating an evidence-based treatment plan is challenging. A case report of a patient with the dual pathology of a composite mucoepidermoid carcinoma of the thyroid and a follicular variant of papillary thyroid carcinoma with malignant metastasis is presented in this article. We discuss the challenges in diagnosis, prognostic factors and management of this rare presentation by reviewing current literature.

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Section: Discussionsupporting

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Composite poorly differentiated mucoepidermoid carcinoma of the thyroid and follicular variant of papillary thyroid carcinoma. Report of a case and review of the literature

Jayakody

Faoury

Fraser

et al. 2019

Journal of Surgical Case Reports

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“…(22-25) Until this report, the presence of cilia in MEC has been restricted to those rare cases arising in the thyroid gland. (26, 27) More than simply a histologic curiosity, the finding of cilia in MEC may pose significant diagnostic difficulties. First, the presence of ciliated cells, especially when presenting as a lateral neck mass, raises the possibility of a benign branchial cleft cyst.…”

Section: Discussionmentioning

confidence: 99%

MAML2 Rearrangements in Variant Forms of Mucoepidermoid Carcinoma

Bishop

Cowan²,

Shum³

et al. 2018

American Journal of Surgical Pathology

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Mucoepidermoid carcinoma (MEC) is the most common salivary gland malignancy. Recent studies have shown that most MECs harbor gene fusions involving MAML2-an alteration that appears to be specific for MEC, a finding that could be diagnostically useful. While most cases of MEC are histologically straightforward, uncommon variants can cause considerable diagnostic difficulty. We present 2 variants of MEC for which MAML2 studies were crucial in establishing a diagnosis: a previously undescribed ciliated variant, and the recently described Warthin-like variant. All cases of ciliated and Warthin-like MEC were retrieved from the archives of The Johns Hopkins Hospital. Break-apart fluorescence in situ hybridization for MAML2 was performed on all cases. One ciliated MEC and 6 Warthin-like MECs were identified. The ciliated MEC presented as a 4.6 cm cystic lymph node metastasis originating from the tongue base in a 47-year-old woman. The Warthin-like MECs presented as parotid masses ranging in size from 1.2 to 3.3 (mean, 2.7 cm) in 4 women and 2 men. The ciliated MEC consisted of macrocystic spaces punctuated by tubulopapillary proliferations of squamoid cells and ciliated columnar cells. The Warthin-like MECs were comprised of cystic spaces lined by multilayered oncocytic to squamoid cells surrounded by a circumscribed cuff of lymphoid tissue with germinal centers. In these cases, the Warthin-like areas dominated the histologic picture. Conventional MEC, when present, represented a minor tumor component. MAML2 rearrangements were identified in all cases. Warthin-like MEC, and now a ciliated form of MEC, are newly described variants of a common salivary gland carcinoma. Unfamiliarity with these novel forms, unanticipated cellular features (eg, cilia), and morphologic overlap with mundane benign processes (eg, developmental ciliated cysts, Warthin tumor) or other carcinomas (eg, ciliated human papillomavirus-related carcinoma) may render these variants susceptible to misdiagnosis. These unusual variants appear to consistently harbor MAML2 fusions-a finding that establishes a clear link to conventional MEC and provides a valuable adjunct in establishing the diagnosis.

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“…The histogenesis of thyroid MEC has been widely debated in the literature. Two major conceivable origins are thyroid follicular epithelial cell [ 6 , 14 , 16 , 17 ] and the cell of solid cell nests (SCN) [ 11 , 18 – 20 ], which is regarded as the vestiges of the ultimobranchial body. Evidence supporting SCN origin is histologic similarities between MEC and SCN [ 9 , 19 ], and existence of ductal structures lined by ciliated columnar epithelial cells in both [ 18 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

A Poor Prognostic Case of Mucoepidermoid Carcinoma of the Thyroid: A Case Report

Shindo

Aishima

Okido

et al. 2012

Case Reports in Endocrinology

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Mucoepidermoid carcinoma (MEC) of the thyroid is very rare and low-grade indolent neoplasm. In past reports of the thyroid MEC, only seven cases were described as poor prognosis. A 91-year-old woman presented with a rapidly growing mass of the left upper neck. She was followed thyroid papillary carcinoma (PC) without operation for two years. Fine needle aspiration cytology (FNAC) showed undifferentiated cells. Total thyroidectomy and bilateral neck dissection were performed. In pathological findings, the tumor had two areas of MEC and PC. The boundary of them was mixed. She died of multiple lung metastases only after four months from the operation. We report a rare case of thyroid MEC which had an aggressive behavior and poor prognosis. This case is a precious in that thyroid MEC occurred during observation of PC and suggests a possibility of the transformation from PC to MEC.

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Composite Follicular Variant of Papillary Carcinoma and Mucoepidermoid Carcinoma of Thyroid Gland: A Case Report

Cited by 17 publications

References 17 publications

Composite poorly differentiated mucoepidermoid carcinoma of the thyroid and follicular variant of papillary thyroid carcinoma. Report of a case and review of the literature

Composite poorly differentiated mucoepidermoid carcinoma of the thyroid and follicular variant of papillary thyroid carcinoma. Report of a case and review of the literature

MAML2 Rearrangements in Variant Forms of Mucoepidermoid Carcinoma

A Poor Prognostic Case of Mucoepidermoid Carcinoma of the Thyroid: A Case Report

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