Tall cell variant papillary thyroid carcinoma in Saudi patients

Abstract

Objectives:To evaluate the clinicopathological features and treatment outcomes of papillary thyroid carcinoma tall cell variant (PTC-TCV) in Saudi population.Methods:This retrospective study were medical records of 776 treated PTC patients between December 2007 and 2015, at King Fahad Medical City and King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia was probed for PTC-TCV. Total 42 (5.4%) patients were found to have PTC-TCV, which were investigated for demographic, symptoms, histopathological features, and treatment outcomes locoregional control (LRC), distant metastasis control (DMC), disease free survival (DFS), and overall survival (OS) rates.Results:Mean age of cohort was 52.3 years (range: 46-80), with female predominance (73.8%). Mean tumor size was 3.62 cm (range: 0.4-10). Rates of LVSI (59.5%), positive pathological lymph nodes (66.7%), multifocality (42.9%) and extrathyroidal extension, (45.3%). Median follow-up was 37.4 months (range: 6-60). Local recurrence rate were seen in 6/42 (14.2%) patients and 8/42 (19%) developed distant metastasis. The 5 year rates of LRC (82.3%), DMC (77.8%), DFS (69.2%), and OS (86.7%) multivariate analysis showed PTC-TVC as an important independent prognosticator (odds ratio: 4.2; 95% confidence interval: 1.79-7.3; p=0.03)Conclusion:Papillary thyroid carcinoma tall cell variant is associated with aggressive biological behavior.

A Comparison of clinicopathological characteristics and short-term outcome of papillary thyroid carcinoma with tall cell histology and classic papillary thyroid carcinoma: A single-institution experience

“…[ 15 ] had reported 7 distant metastases in 62 TCV patients, out of which four were to the lungs, noted after 3 years of follow-up (3.4, 10.6, and 14.6 years). In a Saudi Arabia study[ 16 ] on TCV-PTC defined as >10% tall cells, distant metastasis was seen in 8 out of 42 patients with TCV comparable with ours. Lung involvement was 11.9% much lower than ours.…”

Higher adjuvant radioactive iodine therapy dosage helps intermediate-risk papillary thyroid carcinoma patients achieve better therapeutic effect

“…Research conducted by Ruel et al established a positive correlation between radioactive iodine (RAI) treatment and increased overall survival, noting a 29% reduced risk of death when RAI was administered in the postoperative setting (5). In a similar vein, a study by Al-Qahtani et al presented evidence that adjuvant 131I ablation improves disease-free survival rates in papillary microcarcinoma patients, especially those with poor prognostic factors (14). Before initiating RAI therapy, it poses a significant challenge to distinguish structural or functional disease from thyroid remnants or biochemical disease based on serum thyroglobulin (sTg) levels.…”

An effective approach for BRAF V600E mutation analysis of routine thyroid fine needle aspirates

“…It is the most frequent genetic alteration in PTC, detected in 29%‐83% of cases with a mean of 45% 5,9‐12 . In addition, anaplastic thyroid carcinoma, frequently derived from PTC, can harbour BRAF mutations in 25%‐48% of cases, 13 and the tall cell variant of PTC, a more aggressive variant of PTC, can harbour BRAF mutations in 80%‐100% of cases 14 15‐18 .…”

“…5,[9][10][11][12] In addition, anaplastic thyroid carcinoma, frequently derived from PTC, can harbour BRAF mutations in 25%-48% of cases, 13 and the tall cell variant of PTC, a more aggressive variant of PTC, can harbour BRAF mutations in 80%-100% of cases. 14 The BRAF activating point mutation appears to be highly specific for PTC, with only rare benign lesions or other thyroid follicular neoplasms found to harbour this mutation. [15][16][17][18] According to the 2016 update on diagnosis and management of thyroid nodules, the detection of a BRAF mutation in FNA material can be followed by thyroidectomy without frozen section.…”