Primary Sclerosing Paraganglioma of the Thyroid Gland: A Case Report

Evankovich, John; Dedhia, Raj C.; Bastaki, Jassem M.; Tublin, Mitchell; Johnson, Jonas T.

doi:10.1177/000348941212100803

Cited by 16 publications

(15 citation statements)

References 21 publications

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“…As illustrated by our study, the most important clinical technique for differentiating thyroid paraganglioma from other histologies is IHC. We reviewed the literature finding 48 available case reports (Basu & Viswanathan 2011, Phitayakorn et al 2011, Armstrong et al 2012, Capel 2012, Castelblanco et al 2012, Costinean et al 2012, Evankovich et al 2012, Kieu et al 2012, Mohyuddin et al 2013, Yu et al 2013. Similar to our cases, true thyroid paragangliomas are characterized by immunohistochemical positive staining for chromogranin A (30 of 30 investigated tumors/case), synaptophysin (21/21), S-100 (27/28), and neuron-specific enolase (18/18).…”

Section: Discussionsupporting

confidence: 70%

“…Thyroid paraganglioma is a rare entity with approximately 60 cases that are reported, including our series (LaGuette et al 1997, Yano et al 2007, Ferri et al 2009, González Poggioli et al 2009, Basu & Viswanathan 2011, Phitayakorn et al 2011, Varsavsky et al 2011, Armstrong et al 2012, Capel 2012, Castelblanco et al 2012, Costinean et al 2012, Evankovich et al 2012, Kieu et al 2012, Mohyuddin et al 2013, Yu et al 2013. A major question is whether the rare entity of thyroid paraganglioma is of practical clinical relevance.…”

Section: Discussionmentioning

confidence: 73%

“…Interestingly, two of our paraganglioma patients are males, which is in contrast to the results in the reviewed literature (Basu & Viswanathan 2011, Phitayakorn et al 2011, Armstrong et al 2012, Capel 2012, Castelblanco et al 2012, Costinean et al 2012, Figure 11 Electropherograms of SDHB and SDHA sequence variants identified in cases 1, 3, and 4. Evankovich et al 2012, Kieu et al 2012, Mohyuddin et al 2013, Yu et al 2013.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

A registry-based study of thyroid paraganglioma: histological and genetic characteristics

Dobschuetz

Leijon

Schalin‐Jäntti

et al. 2015

Endocrine-Related Cancer

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Section: Discussionsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 99%

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A registry-based study of thyroid paraganglioma: histological and genetic characteristics

Dobschuetz

Leijon

Schalin‐Jäntti

et al. 2015

Endocrine-Related Cancer

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“…Subsequently, an additional case of sclerosing PG in the paratracheal region causing airway-occlusion was described [13]. More recently, Evankovich and co-workers reported a case of sclerosing PG of the thyroid gland [14]. As in the case we describe, the site of the carotid body and onset in middle-aged females seem the typical clinical presentation of sclerosing PG.…”

Section: Discussionsupporting

confidence: 58%

Sclerosing Paraganglioma of the Carotid Body: A Potential Pitfall of Malignancy

Santi

Franchi

Saladino

et al. 2014

Head and Neck Pathol

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Paragangliomas (PGs) of the head and neck region are typically benign, slow-growing neuroendocrine tumours. At times, they may exhibit unusual histological features, such as prominent stromal sclerosis (sclerosing PG), which may raise concerns of malignancy. We describe a case of sclerosing PG of the carotid body, emphasizing the value of immunohistochemical stains for differential diagnosis. A 43-year-old woman presented with a painless lump on the neck. A magnetic resonance imaging scan demonstrated a hypervascular lesion of the carotid body, which was surgically excised. Grossly, the lesion measured 1.8 cm at maximum diameter. On microscopic examination, irregular nests and tiny bundles of neoplastic cells were found between thick bands of fibrous tissue. Focal nuclear cytomegaly and marked pleomorphism were noted. Neoplastic cells proved to be immunoreactive for chromogranin, synaptophysin and neuron specific enolase, but negative for cytokeratins, smooth muscle actin and CD34. Ultrastructurally, numerous mitochondria, rough endoplasmic reticulum structures and endocrine granules were seen in the cytoplasm of the tumour cells. On consideration of the above-mentioned clinico-pathological and ultrastructural findings a diagnosis of sclerosing PG was established. Sclerosing PG is a rare entity which may mimic a malignant neoplasm. The recognition of this unusual morphological variant of PG, together with appropriate immunostains, leads to the correct diagnosis.

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“…Most tumors were confined within the thyroid capsule. However, in 10 cases the tumors showed extrathyroid invasion, extending into the adjacent organs of trachea, subglottic larynx, esophagus and mediastinum, or involving the recurrent laryngeal nerve [2,7,9,12,13,[17][18][19][20]. In the latter instance, resection of the tumor was very difficult which might result in temporary vocal cord paralysis [2,12].…”

Section: Discussionmentioning

confidence: 99%

Primary Paraganglioma of Thyroid Gland: A Clinicopathologic and Immunohistochemical Analysis of Three Cases with a Review of the Literature

Wei

Wang

2013

Head and Neck Pathol

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Thyroid paraganglioma is an extremely rare tumor and frequently mistaken for other thyroid neoplasms. Increased awareness of its potential presentation in thyroid and its characteristic features is essential for avoiding diagnostic and therapeutic pitfalls. We describe here three additional cases of primary thyroid paraganglioma and analyze their clinical findings and pathological characteristics. Patients included two women and one man presenting with asymptomatic thyroid nodules. Radiological examinations were nonspecific and none had been diagnosed correctly before surgery. On intraoperative frozen section consultation they were all misdiagnosed as carcinomas, either primary or metastatic. However, the permanent sections showed features consistent with paraganglioma. Of note, two cases displayed extension into adjacent thyroid tissues, one of which exhibited increased mitotic activity, confluent tumor necrosis and vascular invasion. Immunohistochemically, the neoplastic chief cells expressed chromogranin, synaptophysin, neuron-specific enolase and CD56, whereas the sustentacular cells were highlighted by S100 protein. All three patients were well with normal hormone secretion, without local recurrence or distant metastasis at last follow-up (range 10-47 months). We further reviewed the literature to summarize the characteristics of this distinctive entity. Albeit being very rare, paraganglioma should be included in the differential diagnosis of hypervascular thyroidal neoplasms. Accurate diagnosis relies on the histopathogical findings and adjunctive immunohistochemcial studies. To date, all the reported cases have pursued a benign course. Although atypical features seem to have no association with clinical behavior, long time postoperative surveillance with biochemical screening of hormone secretion, cervical ultrasonography and whole-body CT scan is recommended.

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Primary Sclerosing Paraganglioma of the Thyroid Gland: A Case Report

Cited by 16 publications

References 21 publications

A registry-based study of thyroid paraganglioma: histological and genetic characteristics

A registry-based study of thyroid paraganglioma: histological and genetic characteristics

Sclerosing Paraganglioma of the Carotid Body: A Potential Pitfall of Malignancy

Primary Paraganglioma of Thyroid Gland: A Clinicopathologic and Immunohistochemical Analysis of Three Cases with a Review of the Literature

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