Mixed Medullary-Follicular Carcinoma of the Thyroid

Abstract

Introduction. Mixed medullary-follicular thyroid carcinoma is an uncommon tumor that consists of both follicular and parafollicular cells. Case. We report a 43-year-old woman with a palpable mass in the right side of the neck. Fine needle aspiration suggested a diagnosis of high grade anaplastic carcinoma that has been associated with papillary features. Total thyroidectomy was done in which histopathological examination showed diagnosis of medullary carcinoma. Immunohistochemical staining was positive for chromogranin, calcitonin, and thyroglobulin in tumoral cells. Conclusion. Mixed medullary-follicular thyroid carcinoma is a rare tumor. Diagnosis of these tumors with fine needle aspiration is very difficult and may lead to misdiagnosis. It is necessary to correlate the cytological finding with serum calcitonin and thyroglobulin. Also immunostaining for calcitonin and thyroglobulin confirms diagnosis.

Mixed subtype thyroid cancer: A surveillance, epidemiology, and end results database analysis

“…It is difficult to identify without immunocytochemical examinations. When fine-needle aspiration cytology is preferred to diagnose such malignancy, adequate specimen and determination of serum calcitonin and thyroglobulin levels would be help for establishing an accurate diagnosis [ 13 - 17 ].…”

Synchronous Hürthle cell and medullary thyroid carcinomas

“…These can present as either mixed, composite or collision tumours 23. Cells in mixed tumours have a common progenitor, displaying immunohistochemical features from both follicular and parafollicular cells 23 24. This is distinct from composite tumours, which contain two discrete cell populations in intimate association 23 25.…”

Appropriate Use Criteria for Nuclear Medicine in the Evaluation and Treatment of Differentiated Thyroid Cancer

“…Similar recommendations are advocated by the National Comprehensive Cancer Network and the British Thyroid Association (110)(111)(112). Because of a lack of efficacy, 131 I use (for imaging and therapy) is not recommended for patients with anaplastic (113,114) or medullary thyroid carcinomas (MTCs) (115,116), although its use should be considered similarly to DTC in those rare cases of MTC in which the tumor is admixed with DTC (116)(117)(118).…”