Thyroid collision tumors; A case series with literature review

Abdullah, Ari M.; Qaradakhy, Aras J.; Ahmed, Mohsin M.; Salih, Abdulwahid M.; Omar, Sami S.; Kakamad, Fahmi H.; Rahim, Hawbash M.; Abdulla, Berwn A.; Mohammed, Shvan H.; Ahmed, Shaho F.; Baba, Hiwa O.; Ishaac, Rivan Hermiz

doi:10.1016/j.amsu.2022.103444

Cited by 5 publications

(7 citation statements)

References 17 publications

(30 reference statements)

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“…In 45 of our 68 cases, two thyroid cancer lesions were located on both sides of the thyroid lobe, accounting for 66.2%.Similar to his findings, no poor prognosis was found for bilateral STC. Consistent with published case reports and reviews [3,8,22,30] our study confirmed that STC often occurs in middle-aged and elderly women, mean age at diagnosis was 51.72 (26-75 )years, male to female ratio was 9:59.The most common manifestations of STC are neck masses and thyroid nodules found by color Doppler ultrasound in health examination. Most of the cases were in the early clinical stage, meaning 66.2% of the cases were in stage I/II, However, 19.1% of patients had distant metastasis, and 11.8% of patients had postoperative recurrence.…”

Section: Discussionsupporting

confidence: 90%

“…Since the pathogenesis of the coexistence of two tumors of different origins in the same thyroid gland is unclear, various hypotheses have been proposed to explain this phenomenon, including the stem cell theory, the random collision effect theory, and the theory that one tumor induces another tumor [8,9,21,22] .The collision effect theory states that tumors are composed of two distinct, separate components. The authors supporting this theory have proposed the term "collision tumor" to refer to these tumors, and our patients mostly have this form-two tumors separated by normal thyroid tissue [23] .Consistent with the Gurkan report [23] the presence of mixed thyroid carcinoma seems to support the stem cell theory.…”

Section: Discussionmentioning

confidence: 99%

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Clinicopathological features and prognostic factors analysis of multiple synchronous distinct subtypes of primary thyroid carcinoma

Dai

Ding

et al. 2022

Endocrine

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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.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Clinicopathological features and prognostic factors analysis of multiple synchronous distinct subtypes of primary thyroid carcinoma

Dai

Ding

et al. 2022

Endocrine

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“…However, a recent case series by Thomas et al have demonstrated disease-free survival in 15 out of 21 (71.4%) of patients with collision tumours, all who have received radical surgery 26. Another case series by Abdullah et al have also demonstrated disease-free survival in six patients who underwent surgical resection 31. Although it is not possible to directly correlate this case’s unique combination of HCC and MTC with results from other individual case reports, they have also shown disease-free survival in patients treated with a combination of radical surgery and adjunct radioiodine, similar to the elected approach in our case 32–38.…”

Section: Discussionmentioning

confidence: 99%

“…There remains debate as to whether both tumours in a collision tumour should be treated separately or if the more aggressive variant should take precedence in guiding management 23 29. Regardless, existing recommendations point towards radical surgery in combination with appropriate adjunct therapy as the mainstay of management, with recognition that this is a complex presentation warranting a patient-specific approach 26 31–40…”

Section: Discussionmentioning

confidence: 99%

Synchronous Hürthle cell and medullary thyroid carcinomas

et al. 2022

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Hürthle cell carcinoma (HCC) and medullary thyroid carcinomas (MTC) are uncommon histological subtypes of thyroid cancers, each accounting for around 3% of all thyroid cancers. A septuagenarian woman with a history of multiple primary cancer diagnoses presented with a growing left-sided neck lump. A diagnostic left thyroid lobectomy was performed, and pathological examination found two separate malignant foci: one HCC and an MTC. The patient developed left-sided HCC nodal metastasis, and following several multidisciplinary team discussions, a right completion lobectomy with left lateral neck dissection was performed, revealing further intrathyroidal MTC and extranodal extension of HCC. We present this as the first reported case of a collision tumour of HCC and MTC, and review the available literature regarding collision tumours and their management.

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“…The former corresponds to a dual differentiation single neoplasm focus, while the latter, called "Collision tumor", refers to two or more histological types coexisting lesions wich are morphologically independent of each other, located in the same organ whereas separated by normal tissue 1,2 . They are quite uncommon in thyroid 3 with few cases reported 3,4 . Among them, "Collision" between MTC and PTC are frequent, while concomitant PTC and Folicular thyroid carcinoma (FTC) are scarce 5 .…”

Section: Introductionmentioning

confidence: 99%

Thyroid collision tumor: a case report of three histological types in the same patient

Paixão¹,

Tabosa²,

Silva³

2023

Arch. Head Neck Surg.

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Concomitant occurrence of two different carcinomas in the same organ is rare. Also, it is quite uncommon in thyroid. In this case, three histological types were diagnosed in the same specimen. A 57-year-old patient with a thyroid nodule history, diagnosed 2 years ago. After a suspicious fine needle aspiration cytological result, total thyroidectomy was performed and the histopathological analysis presented three divergent thyroid tumors. There are few thyroid collision tumors cases described, no one with three different histologic types. The lack of clinical information about it, compelled a judicious management, that guided to a satisfatory outcome.

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Thyroid collision tumors; A case series with literature review

Cited by 5 publications

References 17 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

Synchronous Hürthle cell and medullary thyroid carcinomas

Thyroid collision tumor: a case report of three histological types in the same patient

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