Occult Multifocal Papillary Thyroid Microcarcinoma Presenting as a Supraclavicular Mass Containing Anaplastic Thyroid Carcinoma

Deutschmann, Michael W.; Khalil, Moosa; Bhayana, Shelly; Chandarana, Shamir

doi:10.1001/jamaoto.2013.227

Cited by 7 publications

(5 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Reviewed the literature and found that the lymph node metastasis of Synchronous FTC and PTC was lack of reports, which may be the first case report of lateral lymph node of metastasis of Synchronous FTC and PTC [40] . In our cases, the number of metastatic lymph nodes in the SDDTC was less than 5, while 60% SMDTC and 40% SADTC patients had more than 5 metastatic lymph nodes, which is in line with the relevant reports [5,41,42] . Although there was no significant difference in distant metastasis among the three groups of patients, SDDTC containing FTC was more common in terms of the number of cases with distant metastasis, accounting for 76.9% of STC cases with distant metastasis, It may also be related to the biological characteristics of FTC prone to distant metastasis [43] .But puzzlingly, the first report of distant metastases from synchronous Papillary and Follicular thyroid carcinomas will not appear until 2022 [44] .…”

Section: Discussionsupporting

confidence: 92%

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

Section: Discussionsupporting

confidence: 92%

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

show abstract

“…Most (93%) cervical cystic lymph nodes are CLMPTC 20 because the lymph node metastases of PTC are prone to bleeding, necrosis and cystic changes as their primary thyroid lesions. On the other hand, substantial evidence indicates that many cases with PTC initially present with cystic cervical masses, [6][7][8] and 20% of patients with PTC initially present with cervical masses in the absence of palpable thyroid nodularity. 6 Similarly, in our present study, 69 cases (79.3%) among all 87 CLMPTC cases initially clinically manifested as cystic cervical masses.…”

Section: Discussionmentioning

confidence: 99%

“…It frequently metastasizes to lymph nodes, particularly cervical lymph nodes, but shows rare hematogenous metastasis 3,4 . In the absence of palpable thyroid nodularity, one‐fifth of patients with PTC first present with cervical masses that were proven to be lymph node metastases 5–7 . Among these cervical lymph node metastases from PTC, 70% are cystic 8 .…”

Section: Introductionmentioning

confidence: 99%

Diagnostic strategy of fine needle aspiration cytology of cystic cervical lymph node metastasis from papillary thyroid carcinoma

Liu

Zhang

et al. 2022

Diagnostic Cytopathology

View full text Add to dashboard Cite

Background: Cystic cervical lymph node metastasis from papillary thyroid carcinoma (CLMPTC) initially presents as cervical cystic lesions, which are often underdiagnosed as other cystic cervical lesions. There is no comprehensive diagnostic strategy of fine needle aspiration (FNA) cytology for CLMPTC. Methods:The clinical and FNA cytomorphology data of 87 patients with CLMPTC were analyzed. Thyroglobulin (TG) immunostaining was performed in 40 cases; BRAF V600E mutation was evaluated in 42 cases; the thyroglobulin (Tg) levels of aspiration fluids were assessed in 46 cases. Correspondingly, the data of 42 cases with solid cervical lymph node metastasis from papillary thyroid carcinoma (SLMPTC) and 32 cases with other cystic cervical lesions were collected as controls.Results: Compared with SLMPTC, CLMPTC has less classical PTC cytomorphology characteristics-for example, nuclear crowding/overlapping, nuclear irregular contours, etc. (p < .05). Additionally, micropapillary architecture and histiocyte-like tumor cells were more often observed in CLMPTC than in SLMPTC (p < .01). The positive rate of TG immunocytochemistry in CLMPTC was 100% (40/40). The positive rate of BRAF V600E mutation in CLMPTC was 81.0% (34/42), which was higher than that in SLMPTC (64.3%; 27/42) (p = .087). The Tg levels in aspiration fluids were significantly higher in CLMPTC (all>500 μg/L) than in other cervical cystic lesions (range: 2.9 μg/L to 40.1 μg/L) (p < .01). Conclusion:To reduce underdiagnoses of CLMPTC, a reasonable diagnostic strategy, as summarized in this study is needed: according to the number of tumor cells, choosing immunocytochemistry (TG) and/or thyroglobulin in fine needle aspirates testing as auxiliary diagnostic measures.

show abstract

“…In our case, the old lady presented with neck metastasis showing anaplastic features and later the search for primary disclosed multiple foci of occult PTC. 17 The frequency of synchronous occurrence of AC and PTC is relatively less. Benedict M & CostaJ reported a case who succumbed with metastatic PTC and coexistent AT in multiple sites including bilateral lungs, aorta, pericardium, adrenal, mediastinal, and hilar as well as abdominal lymph nodes.…”

Section: Discussionmentioning

confidence: 99%

Occult multifocal papillary thyroid carcinoma presenting as anaplastic carcinoma in the metastatic neck deposit – A rare case report along with review of literature

Momin¹,

Pol

Gosavi³

et al. 2021

JDPO

View full text Add to dashboard Cite

Papillary thyroid carcinoma (PTC) is the most common type of thyroid carcinoma that carries a favourable prognosis. However, a small subset unfortunately shows transformation to least differentiated anaplastic carcinoma (AC) having a highly aggressive behavior. This process usually occurs within thyroid but is rare in metastatic cervical lymph node or soft tissue neck and exceedingly rare at distant sites. We report a unique case of a 75 years female who presented with anaplastic carcinoma in metastatic neck deposit with occult papillary thyroid carcinoma. To the best of our knowledge, this is the first case in the world literature having anaplastic transformation (AT) in the metastatic neck deposit, right at the presentation with a totally unnoticed PTC clinically. We present this case to emphasize that the transformation process can occur even when the differentiated malignancy in thyroid is small, insignificant or hidden and that metastasis solely can be the presenting feature which can be misleading clinically and even histopathologically. As AC is very aggressive, there is need for early and precise diagnosis & prompt therapeutic intervention.

show abstract

Occult Multifocal Papillary Thyroid Microcarcinoma Presenting as a Supraclavicular Mass Containing Anaplastic Thyroid Carcinoma

Abstract: This is the first instance in the literature in which anaplastic thyroid carcinoma has appeared in metastatic cervical lymph nodes with only a focus of papillary microcarcinoma in the thyroid gland. With this case, we hope to build awareness of this rare finding.

Cited by 7 publications

References 15 publications

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

Diagnostic strategy of fine needle aspiration cytology of cystic cervical lymph node metastasis from papillary thyroid carcinoma

Occult multifocal papillary thyroid carcinoma presenting as anaplastic carcinoma in the metastatic neck deposit – A rare case report along with review of literature

Contact Info

Product

Resources

About