Spindle Epithelial Tumor with Thymus-like Element (Settle): a Case Report

Tavusbay, Cengiz; Etıt, Demet; Kadioglu, Ercan; Hacıyanlı, Mehmet

doi:10.1007/s13193-016-0607-0

Cited by 8 publications

(4 citation statements)

References 7 publications

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“…3 Positive staining for p63 was found in only in two cases in the literature. 2,6 Immunohistochemistry features were consistent with those in the literature in our second patient and Bcl-2 immunoreactivity was also observed. The final diagnosis of SETTLE was determined by immunohistochemistry studies in both patients.…”

Section: Discussionsupporting

confidence: 90%

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Spindle epithelial tumour with thymus-like differentiation: report of two cases

Karaıslı

Hacıyanlı

et al. 2020

annals

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Spindle epithelial tumour with thymus-like differentiation (SETTLE) is a very rare neck malignancy arising from thymic tissue or branchial pouch, mostly seen in the early decades of life. SETTLE is thought to be a low-grade neoplasm but distant metastases have been reported. Fewer than 50 cases have been reported in the PubMed database. We report on the four-year follow-up for a 13-year-old boy, with no signs of recurrence or distant metastasis. In addition, a 45-year-old woman was admitted to hospital with neck mass. Fine-needle aspiration biopsy was compatible with medullary thyroid carcinoma but serum levels of calcitonin were normal. Total thyroidectomy and central compartment lymph node dissection was planned with an initial diagnosis of medullary thyroid carcinoma. At surgery, frozen section analysis converted our diagnosis to SETTLE and the intraoperative strategy was changed. SETTLE should be considered in a patient with normal serum calcitonin levels in the presence of suspicious medullary thyroid carcinoma at fine-needle aspiration biopsy. Frozen section analysis may help to manage the intraoperative strategy. This report describes the first case of SETTLE successfully diagnosed by frozen section analysis.

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Section: Discussionsupporting

confidence: 90%

“…1 To the best of our knowledge, fewer than 50 cases have been reported in the PubMed database. We report two cases of SETTLE, including the four-year follow-up results of a case reported recently 2 and a new case treated successfully.…”

Section: Introductionmentioning

confidence: 97%

Spindle epithelial tumour with thymus-like differentiation: report of two cases

Karaıslı

Hacıyanlı

et al. 2020

annals

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“…SETTLE, which is described as a low grade malignant tumor with a favourable prognosis after complete surgical resection, can have an aggressive course in some cases [ 5 ]. SETTLE patients have long survival despite the development of metastasis [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

When to settle for SETTLE! A lesson learned from our cases

Nagarjun,

Mehta,

Gandhi

et al. 2024

Thyroid Res

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Spindle epithelial tumor with thymic like elements (SETTLE) is a biphasic tumor composed of epithelial and spindle cell components. It is an uncommon indolent tumor arising in the thyroid gland and most commonly affects the children and young adults. This entity is mostly overlooked because of its rarity and diagnostic difficulty on morphology. We discuss two cases of SETTLE with varied presentation, diagnostic challenges and lessons learnt from them.SETTLE should be considered as a differential especially when dealing with a thyroid lesion in young and adolescent. The article discusses the histologic details and common mimickers to be borne in mind aiding in arrival at the final diagnosis on biopsy specimens.

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“…Surgery forms the mainstay of treatment in resectable cases and nodal dissection is unwarranted in node negative cases [3]. Only 47 cases of SETTLE have been documented in indexed literature so far of which only 5 have occurred in older age group patients of more than 50 years [2,[4][5][6][7][8][9][10]. Herein, we report such a case occurring in a 56 year old lady who was treated with surgical resection and remains disease free after a period of 6 months post operatively.…”

Section: Introductionmentioning

confidence: 99%

Spindle epithelial tumor with thymus-like elements (SETTLE): A diagnostic challenge with distinct therapeutic implication; case report

Chadha,

Kamboj,

Pasricha

et al. 2024

Preprint

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Spindle epithelial tumor with thymus-like elements (SETTLE) is a rare malignant neoplasm of the thyroid gland which is believed to arise from intrathyroidal thymic tissue. It predominantly affects young adults and children presenting with a thyroid mass of variable duration and rarely occurs in adults. It has a high overall survival with a tendency for delayed metastasis. SETTLE is a biphasic lobulated tumor composed of spindle shaped cells along with glandular formations seen on histopathological examination. Despite its typical morphology it is commonly misdiagnosed on histopathology due to its rarity and overlapping morphology with other close mimics such as a carcinoma, synovial sarcoma and thymoma. Herein we report such a case occurring in a middle aged female presenting with a neck mass. She had an initial diagnosis of metastatic poorly differentiated squamous cell carcinoma possibly with an orophayngeal primary in view of co expression of CK, p40 and p16 on immunohistochemistry. The patient underwent surgical resection with modified neck dissection. On review at our hospital it was diagnosed as SETTLE and she remains disease free after a follow-up period of 6 months. Diligent histopathological examination espoused with a judicious panel of IHC markers in conjunction with clinicoradiological findings forms the mainstay of diagnosis. Diffuse and strong p16 immunoexpression has not been documented or evaluated in literature so far, and needs to be explored for its diagnostic utility in this rare entity.

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Spindle Epithelial Tumor with Thymus-like Element (Settle): a Case Report

Cited by 8 publications

References 7 publications

Spindle epithelial tumour with thymus-like differentiation: report of two cases

Spindle epithelial tumour with thymus-like differentiation: report of two cases

When to settle for SETTLE! A lesson learned from our cases

Spindle epithelial tumor with thymus-like elements (SETTLE): A diagnostic challenge with distinct therapeutic implication; case report

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