Sclerosing mucoepidermoid carcinoma with eosinophilia of thyroid gland: Not so indolent a neoplasm?

Abstract

A 58-year-old female, a known diabetic and hypertensive, presented with left-sided swelling on the anterior aspect of the neck of 1-year duration, which was rapidly increasing in size for the past 6 months. She was on Eltroxin for hypothyroidism for the past 1 year. Computed tomography study of the neck showed a nodule in the left lobe of thyroid which on fine-needle aspiration was suspicious for malignancy. Total thyroidectomy with left posterolateral lymph node dissection was done. Histopathological examination showed sclerosing mucoepidermoid carcinoma with eosinophilia (SMECE) of the thyroid gland with lymph node metastasis. SMECE of the thyroid was initially thought to be a low-grade malignancy with indolent clinical behavior. However, our case showed extra thyroidal spread with lymph node metastasis, necessitating adjuvant therapy for our patient. Such aggressive behavior has been noted in few earlier case reports also.

Sclerosing mucoepidermoid carcinoma with eosinophilia of the thyroid: Case report of a rare lesion with novel genetic mutation

“…Some patients do well after excision and some die within months due to metastatic disease. This may be due to the murky history of this lesion in the literature and possible confusion with more aggressive entities, such as anaplastic thyroid carcinoma, in other case reports . In this case, the patient is alive and well 15 months post resection with no evidence of disease.…”

Aggressive Primary Thyroid Mucoepidermoid Carcinoma with Extensive Pulmonary Involvement

“…Treatment generally involves total thyroidectomy and cervical lymph node dissection in locally advanced disease. Similar to the management of MECs, conventional chemotherapy, as well as external beam radiation and radioactive iodine therapy, has been employed in the treatment of SMECE, but with little success [32][33][34] Finally, secretory carcinoma (SC) is another type of salivary-like carcinoma of the thyroid, and it was first described in 2010 as a type of neoplasm occurring in salivary glands and resembling breast secretory carcinoma [35]. Since then, it has also been described in the skin, lung, and thyroid [36][37][38].…”