De-differentiation of papillary thyroid carcinoma into squamous cell carcinoma in an elderly patient

Abstract

Rationale: The unpredictability of thyroid cancer can be striking, as the disease may rapidly progress to death in some individuals. Herein, we reported a rare case of aggressive papillary thyroid cell carcinoma (PTC) in an elderly patient de-differentiated into squamous cell carcinoma (SCC). Patient concerns: We describe a case of a 79-year-old Thai woman presented with hoarseness and neck mass for 2 months and she had been diagnosed with a 3-cm papillary thyroid carcinoma (PTC) in the right side of the thyroid gland. Later on PTC de-differentiated into SCC within 3 years after initial presentation. Diagnosis: De-differentiation from papillary thyroid carcinoma to squamous cell carcinoma. Interventions: The patient underwent a total thyroidectomy at the initial hospital and received high dose radioactive iodine (RAI) treatment at our hospital 1 month following the surgery and then was lost to follow-up. Two years later she came back with new development of right solid-cystic neck mass which was found to be recurrent PTC. A radical neck dissection was done and another high dose RAI treatment was given. However, she developed recurrent mass with tenderness at the site above previous solid cystic mass 6 months later. Re-exploration of the neck mass revealed an inflamed midline mass 2 cm with enlarged right lateral cervical lymph nodes. Outcomes: A histopathological examination of the midline neck mass showed poorly differentiated SCC with lymphatic invasion. The intermingling of two morphologically distinct tumors, a typical PTC and a poorly differentiated SCC, had been identified in 1 out of 14 excised cervical lymph nodes. The patient underwent external beam radiation without chemotherapy. She is still in stable condition at 18 months post-treatment. Lessons: This case clearly demonstrated that SCC transformed from a pre-existing PTC. The clinician should consider a possible transformation of papillary thyroid cancer into more aggressive histological types in elderly patients who present with rapidly progressive clinical behavior. However, some patients could have long-term survival if the tumor did not transform into anaplastic thyroid cancer.

Establishment of age group classification for risk stratification in glioma patients

“…There are a variety of indicators that are widely used in clinical practice (such as GFAP, EMA, MGMT, P53, NeuN, Oligo2, EGFR, VEGF, IDH1, Ki-67, 1p/19q), and these indicators are highly correlated with the prognosis of the patients [ 34 – 36 ]. Age-dependent occurrence and the effects of different biological markers have been reported in malignancies [ 37 ]. For example, the association between age and tumor grade, Ki-67 markers, apoptosis index, EGFR expression and erbB-2 expression has been reported in breast cancer [ 38 ].…”

Ultrasonic Characterization of Primary Squamous Cell Carcinoma of the Thyroid

“…In our study, only one PSCCT was combined with HT. PSCCT has been reported to be combined with HT and other thyroid malignancies, 11,13–16 which supports the second theory. However, the origin of most cases, including the remaining PSCCTs in our study and the ones reported in other studies 1,4,17 remains unclear, indicating that the origin of PSCCT requires further investigation.…”

Prognosis of Oligodendroglioma Patients Stratified by Age: A SEER Population-Based Analysis

“…Many reports have demonstrated the close connections between biomarkers and age. 28 For example, in breast cancer, age is closely related to tumor grading and EGFR and HER-2 expressions. 29 However, no molecular detection data in OG patients are available from the SEER database.…”