[Thyroid squamous-cell carcinoma showing thymus-like element (CASTLE): a report of eight cases].
Da J,Shi H,Lu J
Zhonghua zhong liu za zhi [Chinese journal of oncology]
OBJECTIVE:To report 8 cases of squamous-cell carcinoma showing thymus-like element (CASTLE) of the thyroid. METHODS:Clinical data and pathological sections were retrospectively reviewed. RESULTS:CASTLE of the thyroid differed from ordinary squamous-cell carcinoma (SCC) in that it not only presented typical squamous pattern of differentiation, but also admixed with thymic architecture, such as Hassall's corpuscles, lymphoepithelial-like structure and mature lymphocyte infiltration in the stroma. CASTLE of the thyroid and much better prognosis than that of the ordinary SCC of the thyroid with a median survival time of 10.5 year. Histogenesis of CASTLE was discussed. CONCLUSION:Thyroid CASTLE is of rare occurrence. It should be distinguished from SCC of thyroid in order to treat such patients adequately.
Primary squamous cell carcinoma of the thyroid--a case report.
Wan Muhaizan W M,Phang K S,Sharifah N A,al Amin D
The Malaysian journal of pathology
A rare case of primary squamous cell carcinoma of the thyroid is reported herein. A 64-year-old Malay lady presented with a gradually enlarging thyroid nodule for the past 6 months and underwent total thyroidectomy. Histopathology revealed a squamous cell carcinoma of the thyroid with complete resection. Possible primary tumour elsewhere was excluded. Postoperative irradiation was given and patient is still alive after 2 years of follow-up.
Squamous cell carcinoma of the thyroid: outcome of treatment in 16 patients.
Cook A M,Vini L,Harmer C
European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
AIMS AND METHODS:Squamous cell carcinoma of the thyroid is very rare and has a poor prognosis. Treatment and outcome were retrospectively analysed in a consecutive series of 16 patients treated at the Royal Marsden Hospital, with the aim of establishing guidelines for management. RESULTS:Twelve of the 16 patients had locoregional disease only at presentation and four had distant metastases. Eight of the 16 underwent surgery and four were given post-operative radiotherapy. Radiotherapy alone was used in six patients unsuitable for surgery. Median survival was 16 months. There were three long-term survivors; each had localized disease treated with surgery and post-operative radiotherapy. Patients treated with surgery alone all developed local recurrence. Two of six patients treated with radiotherapy alone had a partial response but all subsequently developed progressive local disease. Chemotherapy was used in two patients with no response. CONCLUSIONS:Long-term survival is possible if disease is diagnosed early and is completely resected. Surgery should be followed by radical dose radiotherapy.
Squamous cell carcinoma of the thyroid: an aggressive tumor associated with tall cell variant of papillary thyroid carcinoma.
Kleer C G,Giordano T J,Merino M J
Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc
Squamous cell carcinoma of the thyroid (SCT) is an unusual neoplasm thought to arise as a primary tumor or as a component of an undifferentiated carcinoma. The role of p53 and Ki-67 as prognostic indicators in this type of tumor is not known. We studied eight cases of primary SCT. Three cases were analyzed for Ki-67 by immunohistochemistry and for p53 by immunohistochemistry and loss of heterozygosity. Seven patients were women, and one was a man (age range, 31 to 90 years). SCT were firm, were tan with areas of necrosis, and ranged in size from 2 to 8 cm. Histologically, they had islands of squamous cells with spindle cell areas (two of eight). In four of eight cases, SCT was associated with the tall cell variant of papillary carcinoma (TCV). Positive staining for p53 was seen in two of three cases, and in one of three the TCV was also positive for p53. Mean MIB1 labeling index was 30% and 17% in SCT and TCV, respectively. At the time of presentation, six of eight patients had cervical lymph node metastases. In one case, the primary tumor had SCT and TCV; however, only the SCT component metastasized. After mean follow-up of 48 months, one patient had died of disease, five were alive with recurrent or metastatic tumor, and two were lost to follow-up. Primary SCT is an aggressive neoplasm that may be found in association with TCV. p53 expression and high MIB1 labeling index occur in these tumors and may be useful prognosticators.
Squamous cell carcinoma of thyroid gland.
Agrawal R,Tandon V,Agrawal A,Agrawal G,Krishnani N,Mishra S K
The Journal of the Association of Physicians of India
We present the clinical manifestation, management and outcome in two cases of squamous cell cancer arising in the thyroid gland which is a rare entity. Both cases had advanced disease invading adjacent structures. At the followup of three to six months, one patient developed recurrence and died.
Primary squamous cell carcinoma of the thyroid gland: an entity with aggressive clinical behaviour and distinctive cytokeratin expression profiles.
Lam K Y,Lo C Y,Liu M C
AIMS:Primary squamous cell carcinoma of the thyroid gland is uncommon. This study aims to identify the clinicopathological features and the pattern of expression of cytokeratins and oncoproteins in this tumour. METHODS AND RESULTS:Histological slides from Chinese patients with thyroid cancer treated in our institution from 1980 to 1999 were reviewed. Patients with primary squamous cell carcinoma of the thyroid were identified and their clinical records were analysed. The expression of cytokeratins (CKs), p53 and p21 in these cases were also studied by an immunohistochemical method. Four women (mean age 71 years) with squamous cell carcinoma of thyroid were found. The main presenting features were signs and symptoms of airway obstruction in three patients and neck swelling in one. The tumours were located at the right lobe (n=2), left lobe (n=1) or in both lobes of the thyroid (n=1). One patient died shortly after admission and the other three died within 4 months after thyroidectomy. The p53 protein was positive in 50% (2/4) of the tumours and p53+ tumours were poorly differentiated. The tumours were negative for p21. CK19 was expressed in all the tumours while CK7 expression was noted in 3/4 of the tumours. One carcinoma showed focal positivity to CK18. The tumours were negative for CKs 1, 4, 6, 10/13 and 20. The pattern of cytokeratin expression in squamous cell carcinoma of the thyroid gland was different from carcinoma showing thymus-like differentiation (CASTLE) of the thyroid gland and oesophageal squamous cell carcinoma. CONCLUSIONS:Squamous cell carcinoma of the thyroid has aggressive clinical behaviour and characteristic CK expression pattern. p53 over-expression in these tumours was associated with tumour differentiation.
Primary squamous cell carcinoma of the thyroid.
European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
AIMS:To investigate the clinical features and treatment protocol of squamous cell carcinoma of the thyroid (SCCT). METHOD:Clinical records of four SCCT patients treated during 1985--99 were retrospectively reviewed and evaluated. RESULTS:Two patients who underwent surgical excision plus radiotherapy died of local tumour recurrence, 6 and 13 months, respectively, post-operatively. One who accepted surgery only died 4 months later of respiratory distress. The fourth patient who had radical surgery coupled with radiotherapy and chemotherapy was disease-free at 26-month follow-up. CONCLUSION:SCCT is a very rare but highly malignant carcinoma. Early diagnosis and an aggressive radical surgery portend a better prognosis. Radiotherapy and chemotherapy are secondary applicable methods for the patients with certain condition.
Diffuse sclerosing variant of papillary thyroid carcinoma with primary squamous cell carcinoma.
Kebapci N,Efe B,Kabukcuoglu S,Akalin A,Kebapci M
Journal of endocrinological investigation
A case of a very rare combination of diffuse sclerosing variant of papillary thyroid carcinoma (DSPC) and primary squamous thyroid carcinoma (PSC) is presented. A 25-yr-old woman with right-sided neck mass and hypothyroidism was admitted. US showed that the right lobe of the thyroid gland was enlarged with irregular margins and heterogen echogenity and there were multiple small punctate echogenic foci in the central portion. A scintigraphy with 99mTc showed decreased uptake in the right lobe. FNA of the right lobe induced us to consider the presence of follicular neoplasm. Chest roentgenogram was normal. Total thyroidectomy with right-sided modified radical neck dissection was performed. Findings related to Hashimoto's thyroiditis and abundant psammoma bodies were observed in the frozen sections. Histopathologic findings demonstrated the coexistence of DSPC and PSC in both lobes and 16 lymph nodes metastases and soft tissue infiltration. Radioiodine was administered to ablate residual thyroid tissue. She was given T4 suppression therapy. At the 44th month of follow-up, she remains well without recurrences and metastases. The coexistence of DSPC and thyroiditis or PSC is still under debate. Very few cases with the combination of papillary thyroid carcinoma and PSC have been reported previously, thus we discuss the clinico-pathologic features and possible explanation for this unusual coexistence of malignancies.
Primary squamous-cell carcinoma of the thyroid gland: new evidence in support of follicular epithelial cell origin.
Sahoo Maheswar,Bal C S,Bhatnagar Dinesh
Primary squamous-cell carcinoma (SCC) of the thyroid gland is extremely rare. We had an opportunity to treat two such cases recently. Two elderly females presented with left lobe thyroid swelling that had a history of long-standing goiter. Fine-needle aspiration (FNA) of the thyroid nodule was done in both cases. FNA cytology showed an thyroid abscess in the first, and a Hürthle-cell neoplasm in the second case. Histopathologic diagnosis was a well-differentiated squamous-cell carcinoma with an adjacent area of lymphocytic thyroiditis in the first case, and a moderately differentiated squamous-cell carcinoma in association with a Hürthle-cell adenoma in the second case. Serial sections of the excised gland ruled out any other associated thyroid malignancy. Immunostaining for pan-cytokeratin, thyroglobulin, and calcitonin were performed. The tumor, comprising polygonal and spindle cells, showed positive staining for cytokeratin and thyroglobulin; however, calcitonin did not stain any structures. Exhaustive clinical, endoscopic, and radiological examinations, i.e., X-ray of the chest, contrast-enhanced computer tomography (CECT) of the neck and chest, and ENT checkup in both cases did not reveal any primary site of squamous-cell carcinoma as the likely source of the metastases, or any contiguous spread from neighboring structures. Both patients had ipsilateral nodal metastases, and both succumbed to the disease within 6 mo of histological diagnosis. The interesting observation in both cases was thyroglobulin positivity, indicating a follicular epithelial cell origin of the SCC.
Primary squamous cell carcinoma of the thyroid gland.
Zimmer Peter W,Wilson David,Bell Norman
A case of primary squamous cell carcinoma of the thyroid is presented. Squamous epithelium is normally not present in the thyroid gland, and this tumor is exceedingly rare. Proper workup is described, including the differentiation from metastatic disease. The case reported is of a 64-year-old woman who presented with an asymptomatic nodule and underwent thyroidectomy. The final pathologic diagnosis, confirmed using immunohistochemistry for cytokeratin and transmission electron microscopy, revealed the unusual tumor. Squamous cell carcinoma of the thyroid is highly aggressive and behaves clinically like anaplastic thyroid carcinoma; the prognosis is poor. The patient described developed local recurrence and expired 7 months after resection from local invasion and airway obstruction. Unfortunately, this is the typical outcome. Chemoradiotherapy is generally not helpful, and complete resection remains the best chance for cure.
[A case of primary squamous cell carcinoma of the lung with a metastatic thyroid tumor improved following chemotherapy].
Hirama Michihiro,Takahashi Kazuhisa,Takagi Yumiko,Ohhashi Rina,Suzuki Koji,Sato Koichi,Seyama Kuniaki,Uekusa Toshimasa,Fukuchi Yoshinosuke
Nihon Kokyuki Gakkai zasshi = the journal of the Japanese Respiratory Society
Metastatic thyroid tumor is rarely diagnosed clinically. We report here a case of a 59-year-old male of a primary squamous cell carcinoma of the lung with metastatic thyroid tumor diagnosed by an ultrasonography-guided aspiration cytology. A squamous cell carcinoma of the lung (c-T4N3M1 stage IV) was diagnosed in March 2001, and so chemotherapy using carboplatin and paclitaxel was tried initially. A partial response was obtained. Then, he was re-admitted to our hospital because his thyroid gland was swollen. Ultrasonography-guided aspiration cytology of the thyroid tumor was performed and revealed a metastatic squamous cell carcinoma from the lung cancer. The patient was given chemotherapy using gemcitabine and docetaxel as second line chemotherapy. This reduced the thyroid tumor size and improved the symptoms.
Squamous cell carcinoma arising in a tall cell papillary carcinoma of the thyroid.
Sutak J,Armstrong J S,Rusby J E
Journal of clinical pathology
Transformation of differentiated thyroid cancer into poorly differentiated carcinoma is rare. This report describes a case in which preoperative fine needle aspiration suggested a squamous cell carcinoma whereas needle core biopsy favoured an undifferentiated carcinoma of probable thyroid origin. Histology of the subsequent total thyroidectomy specimen revealed a biphasic tumour comprising areas of tall cell papillary carcinoma merging with moderately to poorly differentiated squamous cell carcinoma. The immunohistochemical findings are discussed in detail.
Squamous cell carcinoma of esophagus masquerading as solitary thyroid nodule.
Basu S,Nair N,Borges A M
Indian journal of cancer
Secondary neoplasm of the thyroid mimicking a primary thyroid lesion is a rare finding, especially in an individual without a past history of malignancy. A case of squamous cell carcinoma metastatic to the thyroid (presenting as a solitary thyroid nodule), who had an unsuspected primary in the esophagus is described. Usually, multiple areas of the gland are involved in the secondary involvement of the thyroid. The clinical presentation of an apparently asymptomatic mass with neck lymphadenopathy, normal thyroid functions, and a cold nodule on 99mTcO4- thyroid scan can often lead to a misdiagnosis as primary thyroid neoplasm. The present case underscores the fact that due importance to the subtle signs and symptoms and a high degree of suspicion, whenever the histology is unusual for a thyroid primary, is needed and the workup should include ruling out other primary malignancies.
Thyroid papillary carcinoma recurring as squamous cell carcinoma: report of a case.
Kitahara Shinzo,Ito Toshihide,Hamatani Shigeharu,Shibuya Kazutoshi,Shiba Tadaaki
We report a case of local squamous cell carcinoma recurrence of thyroid papillary carcinoma, 4 years after subtotal thyroidectomy, in an 82-year-old woman. The papillary cancer of the right thyroid was histopathologically classified as T2a, N0, M0, Ex1; pT2a, pN1b, pEx1; Stage III. Fine-needle aspiration cytology of the recurrent tumor revealed atypical squamous epithelium-like cells with keratinization. The tumor was judged cytologically to be class III, defined as a suspicious malignancy and, after reoperation, it was diagnosed histopathologically as papillary carcinoma recurrence with extensive squamous metaplasia. The recurrent papillary carcinoma was thought to have changed to a squamous cell carcinoma because most of the tumor was occupied by atypical squamous cells, with a small amount of glandular tissue. The primary tumor was histologically diagnosed as a well-differentiated papillary carcinoma at the initial operation. It contained numerous tall neoplastic cells with eosinophilic granules and pseudostratified nuclei, indicating that it could potentially transform into squamous cell carcinoma. We report this case as an example of how squamous cell carcinoma of the thyroid can develop.
Primary squamous cell carcinoma of the thyroid: report of ten cases.
Booya Fargol,Sebo Thomas J,Kasperbauer Jan L,Fatourechi Vahab
Thyroid : official journal of the American Thyroid Association
OBJECTIVES:To define the clinical and pathologic characteristics of primary squamous cell carcinoma of the thyroid (PSCCT), a rare tumor, and compare it to the more common secondary squamous cell carcinoma of the thyroid (SSCCT). MATERIALS AND METHODS:A search of tumor registry and medical archives of our institution identified 24 cases of squamous cell carcinoma involving the thyroid in a 25-year period (1978-2003). Medical records and pathology specimens were reviewed. This investigation did not reveal other primary sites in 10 (PSCCT). Other primary sites were identified in 14 patients (SSCCT). Immunostaining was done for thyroglobulin, cytokeratin (7 and 19), thyroid transcription factor (TTF), calcitonin, p21, MIB-I, and p53. RESULTS:All 10 PSCCTs presented with a rapidly enlarging neck mass. Excision was possible in 8. PSCCT had the following features on immunostaining: keratin (8/8, 100%), thyroglobulin (5/8, 62.5%), TTF positive (3/8, 37.5%), and calcitonin negative. Cytokeratins 7 and 19 were diffusely and strongly positive in the PSCCT. Expression of putative biomarkers p21, MIB-I, and p53 was elevated with PSCCT cells showing mean expression of 36%, 48%, and 39%, respectively, compared to less than 5% in non-neoplastic tissues. The mean survival from diagnosis was 8.6 months. All patients died of disease. Airway compromise was the cause of death in the majority. In SSCCT, positivity for thyroglobulin and TTF was not seen. The locations of the primary sites were: larynx (7; 50%), trachea (4; 29%), esophagus (2; 14%), and oral cavity (1; 7%). At last follow-up, 4 were alive with mean survival of 5.5 years. Six had cancer-related mortality with mean survival of 46 months. CONCLUSION:PSCCT is an aggressive cancer with death occurring within the first year in most patients. The prognosis for patients with PSCCT is worse than SSCCT. p21, MIB-I, and p53 are overexpressed in PSCCT. Thyroglobulin and TTF can show focal positivity in PSCCT distinguishing it from SSCCT.
A patient with primary squamous cell carcinoma of the thyroid intermingled with follicular thyroid carcinoma that remains alive more than 8 years after diagnosis.
Jung Tae Sik,Oh Young Lyun,Min Young-Ki,Lee Myung-Shik,Lee Moon-Kyu,Kim Kwang-Won,Chung Jae Hoon
The Korean journal of internal medicine
Primary squamous cell carcinoma of the thyroid is an extremely rare tumor with a highly aggressive clinical course. We report here on a patient with primary squamous cell carcinoma of the thyroid who remains alive more than 8 years after diagnosis. A 56-year-old man presented with a hoarse voice and a rapidly progressing mass on the right side of the thyroid gland. The patient underwent a total thyroidectomy without neck lymph node dissection. Histopathologic findings revealed primary squamous cell carcinoma combined with follicular carcinoma of the thyroid. The tumors metastasized to the cervical lymph nodes, thoracic spine and lung. He underwent 5000 rads of adjuvant radiotherapy to the neck. TSH suppressive therapy with L-thyroxine was administered alone rather than radioactive iodine therapy or chemotherapy. The patient's clinical course has been remarkable over the first 7 years; he has remained stable except for a transient paraplegia due to nerve compression. The patient underwent colectomy for the diagnosis of a colon cancer. Recent evaluation has revealed a new lesion in the lung; this was diagnosed as metastatic follicular carcinoma originating from the thyroid. High dose radioactive iodine therapy was administered, and he remains alive in stable condition.
Primary squamous cell carcinoma of the thyroid arising in Hashimoto's thyroiditis in an adolescent.
Sanchez-Sosa Sergio,Rios-Luna Nina Paola,Tamayo Bricia del Rosario,Simpson Karen,Albores-Saavedra Jorge
Pediatric and developmental pathology : the official journal of the Society for Pediatric Pathology and the Paediatric Pathology Society
Squamous cell carcinoma is a rare thyroid neoplasm that has been described exclusively in adults. We report what appears to be the first example of a primary squamous cell carcinoma of the thyroid gland arising in a background of Hashimoto's thyroiditis in an adolescent female. The tumor was well demarcated, confined to the right thyroid lobe, and did not metastasize, although follow up has been limited. The squamous cell carcinoma was well to moderately differentiated, and the stroma contained an abundant inflammatory infiltrate rich in lymphocytes and eosinophils. The lack of goblet cells, extracellular mucin, and extensive stromal sclerosis excluded the diagnosis of sclerosing mucoepidermoid carcinoma with eosinophilia. Immunohistochemical staining revealed focal expression of cytokeratin 7 and diffuse labeling with cytokeratin AE1/AE3. The squamous cell carcinoma overexpressed p53 protein and showed increased proliferative activity, as evidenced by the high MIB-1 labeling index. In contrast, the tumor did not show immunoreactivity for thyroglobulin or thyroid transcription factor 1.
Is an aggressive approach justified in the management of an aggressive cancer--the squamous cell carcinoma of thyroid?
Chintamani ,Kulshreshtha Pranjal,Singh Jaiprakash,Sugandhi Nidhi,Bansal Anju,Bhatnagar Dinesh,Saxena Sunita
International seminars in surgical oncology : ISSO
BACKGROUND:Primary squamous cell carcinoma of the thyroid is an extremely rare neoplasm, with less than 50 cases reported in the world literature. The prognosis is poor with a median survival of less than six months. The death is usually secondary to progression of local disease as distant metastases are rare. CASE REPORTS:Three cases, two males and one female presenting with sudden increase in the size of long standing thyroid swellings and associated pressure effects on the aero-digestive tract are reported. Exhaustive clinical, endoscopic, and radiological examinations did not reveal any primary site of squamous-cell carcinoma as the likely source of the metastases, or of any contiguous spread from neighboring structures. Two cases were managed by combined modality therapy including curative surgery with radiotherapy and one by radiotherapy alone. CONCLUSION:Primary squamous cell carcinoma is a rare malignancy with a poor outcome inspite of combined modality therapy. Out of three reported cases, two succumbed to their disease within less than one year. Aggressive surgery in the form of curative resection along with adjuvant radiotherapy is recommended, the tumor being chemo resistant.
[Squamous cell carcinoma arising in a papillary carcinoma of the thyroid: a case report].
Maamouri Fathia,Goucha Aida,Ben Mna Nedra,Ben Hassouna Jamel,Debbabi Boutheina,Ouslati Zeineb,Boussen Hamouda,El May Ahmed,Gamoudi Amor
La Tunisie medicale
BACKGROUND:primary squamous cell carcinoma (scc) of the thyroid is a rare malignant tumor that needs to be distinguished from other neoplasms. Cases of papillary carcinoma merging in association with squamous cell carcinoma are extremely rare. AIM:the characteristics of such association will be studied herein through a review of literature. CASE REPORT:we report a case of an 87-year-old patient presented with an enlarged right lobe of the thyroid. Thyroid scintigraphy revealed a cold nodule. Clinically, malignancy was suspected. Histopathologic diagnosis was a well-differentiated scc associated with areas of papillary carcinoma. Exhaustive clinical, endoscopic and radiological examinations did not reveal any primary site of scc or any contiguous spread from neighboring structures. Surgery was followed by radiotherapy, but the patient died 6 months later. CONCLUSION:the coexistence of epidermoide and papillary carcinomas in the thyroid gland must be known because of its prognostic impact.
Primary squamous cell carcinoma of the thyroid: immunohistochemical profile and literature review.
Fassan Matteo,Pennelli Gianmaria,Pelizzo Maria Rosa,Rugge Massimo
BACKGROUND:Squamous cell carcinoma accounts for 1% of primary thyroid malignancies and is characterized by a rapidly unfavorable outcome. CASE PRESENTATION:A 64-year-old woman presented with a painless mass in the left neck, coexisting with thyroid goiter. Total thyroidectomy with lymphadenectomy was performed and a primary thyroid squamous cell cancer was confirmed histologically after excluding any other possible primary malignancies. The tumor's immunohistochemical profile was explored using a large panel of antibodies. The tumor featured a positive immunoreaction to cytokeratins 7-19 and to squamous cell carcinoma antigen. Low-molecular-weight cytokeratins 5-6 and epithelial membrane antigen were also expressed. The neoplasm's proliferative index (Mib1) was 60%. No immunostaining was detected for cytokeratins 10-20, thyroglobulin, TTF-1, CD5, galectin-3 or p53. CONCLUSIONS:This case of primary thyroid squamous cell carcinoma immunohistochemically profiled using a large panel of immunoreactions may offer useful information on the histological differentiation of thyroid squamous cell carcinoma from other (uncommon) thyroid carcinomas and the distinction between primary and secondary thyroid cancers.
Primary squamous cell carcinoma of the thyroid: report of three cases.
Makay Ozer,Kaya Tayfun,Ertan Yesim,Icoz Gokhan,Akyildiz Mahir,Yilmaz Mustafa,Tuncyurek Muge,Yetkin Enis
We report three cases of squamous cell carcinoma of the thyroid, which is an unusual malignant tumor that needs to be distinguished from other thyroid pathologies due to its aggressive behaviour. Three men, with an average of 63 years old, presented with progressive enlargement in the neck, hoarse voice or weight loss. Physical and radiological examinations revealed clues where malignancy was suspected and surgical resections were performed. Histopathological examination of the specimens was diagnosed as squamous cell carcinoma. Proper workup excluded the possibility of any primary site of SCC other than the thyroid. All patients died within 5 months. Adjuvant therapy evaluation is still inconclusive. Complete surgical resection still remains the primary choice for cure. We believe that radical resection with clear surgical margins followed by adjuvant chemo-radiation therapy is a curative strategy for achieving any chance of long-term survival.
Coexistence of primary squamous cell carcinoma of thyroid with classic papillary thyroid carcinoma.
Eom Tae Ik,Koo Bon Yong,Kim Byung Seup,Kang Kyung Ho,Jung Seung Ku,Jun Sun-Young,Bae Hoon Sik,Kim Lee Su
Primary squamous cell carcinoma of the thyroid gland is very rare and its histogenesis is poorly defined so far. Although there have been some cases of squamous cell carcinoma with variant types of papillary thyroid carcinoma (PTC), the present case is the first primary squamous cell carcinoma with classic PTC to be reported. A 43-year-old woman presented with a 20 year history of neck mass. Neck ultrasound indicated a 6x4x3 cm large mass. The patient underwent total thyroidectomy. Histopathology indicated a well-differentiated squamous cell carcinoma and squamous metaplasia in conjunction with classic PTC. On immunohistochemistry cytokeratin 7 was positive in papillary carcinoma and squamous metaplasia, thyroglobulin was positive only in papillary carcinoma, and p63 was positive in squamous metaplasia and squamous cell carcinoma. Postoperatively, the patient received 59.4 Gy adjuvant radiotherapy, hormonal therapy and radioactive iodine therapy. At 8 months after surgery the patient remained disease free.
EGFR expression in primary squamous cell carcinoma of the thyroid.
Long Jennifer L,Strocker Ali M,Wang Marilene B,Blackwell Keith E
We present the case of a 57-year-old male with primary squamous cell carcinoma of the thyroid (PSCCT). Epidermal growth factor receptor (EGFR) staining was strongly positive. Pharmaceuticals targeting EGFR may provide an additional therapeutic option for this rare disease with extremely poor prognosis.
[Treatment and prognosis of squamous cell carcinoma of thyroid].
Wu Yaohong,Sun Chuanzheng,Xi Yan,Sun Ruimei,Fe Jimin,Li Xiaojiang,Sui Jun
Lin chuang er bi yan hou tou jing wai ke za zhi = Journal of clinical otorhinolaryngology, head, and neck surgery
OBJECTIVE:To investigate the treatment and prognosis of the patients with squamous cell carcinoma of thyroid. METHOD:The clinical data of all patients with squamous cell carcinoma of the thyroid in our hospital from Dec. 1994 to Dec. 2008 were analyzed retrospectively. RESULT:The overall 1-year, 3-year survival rates were 36.4% and 9.1% respectively. The median survival time was 8 months. Survival analysis showed the patients receiving surgery and postoperative radiotherapy had a better prognosis. CONCLUSION:The prognosis of squamous cell carcinoma of thyroid was poor; the patients with squamous cell carcinoma of thyroid maybe get a better prognosis by receiving surgery and postoperative radiotherapy.
Primary squamous cell carcinoma of the thyroid years after radioactive iodine treatment.
Yucel H,Schaper N C,van Beek M,Bravenboer B
The Netherlands journal of medicine
Primary squamous cell carcinoma (SCC) of the thyroid gland is a rare diagnosis, since there is no squamous epithelium in the thyroid gland. SCC of the thyroid is highly aggressive with a poor prognosis. We present a case of primary SCC of the thyroid: this 88-year-old male patient had a history of hyperthyroidism which was treated with radioactive iodine 25 years earlier. Whether this treatment could be related to SCC of the thyroid is not clear. We treated our patient with thyroidectomy and subsequent intensified radiotherapy. Six months after treatment our patient is doing well and there is no sign of local reoccurrence. Our work-up is described, including the differentiation from metastatic disease. The origin of squamous cell carcinoma in the thyroid is uncertain; we discuss some theoretical considerations. We conclude that after excluding metastatic disease, thyroidectomy combined with radiotherapy is the treatment of choice.
EGFR polysomy in squamous cell carcinoma of the thyroid. Report of two cases and review of the literature.
Bonetti Luca Reggiani,Lupi Massimo,Trani Margherita,Trani Nicoletta,Sartori Giuliana,Schirosi Laura,Bettelli Stefania,Zanelli Giuliana,Maccio Livia,Maiorana Antonio
AIMS AND BACKGROUND:Primary squamous cell carcinoma of the thyroid gland (PSCCT) is an uncommon malignancy characterized by a poor prognosis. A radical surgical approach combined with radiotherapy or chemotherapy is the generally accepted treatment for this tumor. The epidermal growth factor receptor (EGFR) is a transmembrane tyrosine kinase receptor modulating the cell proliferation and biological progression of many human epithelial tumors. The EGFR overexpression in PSCCT suggests an additional therapeutic option for the treatment of this tumor. METHODS AND STUDY DESIGN:The clinicopathological features and immunohistochemical profiles of two cases of primary squamous cell carcinoma of the thyroid in a 66-year-old and an 83-year-old woman are presented. EGFR status was valued in both cases. RESULTS:Overexpression of EGFR protein was detected in 50% and 75% of the tumor cell membranes. EGRF gene polysomy was detected in both tumors. CONCLUSIONS:Pharmaceuticals targeting EGFR may help to provide the rationale for an additional, novel therapeutic option for this rare tumor, especially when other therapeutic options have been exhausted.
Squamous cell carcinoma associated with tall cell variant of papillary carcinoma of the thyroid.
Ashraf M J,Azarpira N,Khademi B,Peiravi M
Indian journal of pathology & microbiology
We report the simultaneous occurrence of the tall cell variant of papillary carcinoma and squamous cell carcinoma in the thyroid gland. Histology and immunohistochemical findings are discussed and it seems that the malignant squamous component was transformed from the tall cell variant of papillary carcinoma. Metastasis from the squamous cell carcinoma is diagnosed in the regional lymph node.
Primary squamous cell carcinoma of the thyroid: an unusual presentation.
Batchelor Nicholas Kevin
Journal of bronchology & interventional pulmonology
Primary squamous cell carcinoma of the thyroid (PSCCT) is a rare malignancy with a poor prognosis. PSCCT usually presents as an enlarging neck mass and can cause stridor, hoarseness, and shortness of breath because of its penchant for local invasion. Long-term survival requires early detection and complete surgical excision, as the tumor is resistant to chemotherapy and radiation therapy. We present a patient with PSCCT without evidence of neck mass on presentation, who presented instead with shortness of breath, stridor, and evidence of an upper airway obstruction on spirometry. Recognition of a possible airway obstruction led to bronchoscopy, identification of the endobronchial obstruction, and successful definitive resection of the malignancy.
Primary pure squamous cell carcinoma of the thyroid: report and histogenic consideration of a case involving a BRAF mutation.
Ko Young Sin,Hwang Tae Sook,Han Hye Seung,Lim So Duk,Kim Wan Seop,Oh Seo Young
Primary squamous cell carcinoma of the thyroid (SCC-T) is extremely rare. Its clinical presentation is similar to that of anaplastic carcinoma. Metastasis or extension from the head and neck area should be ruled out, as patients with SCC-T have a poorer prognosis than patients who have a thyroid extension from an adjacent tumor. An 87-year-old man presented with a longstanding painless mass in the right thyroid and had experienced 2 months of pain upon swallowing. A right lobectomy was performed with resection of thyroid cartilage, cricoid cartilage, a portion of the first to third tracheal ring and the right neck lymph node. A histological examination revealed pure SCC. The tumor cells showed diffuse immunoreactivity to CK5/6, CK19 and p63. Immunoreactivity to EMA and p53 was focally positive. TTF-1, galectin 3 and thyroglobulin immunoreactivity was restricted to the non-neoplastic thyroid tissue. Both tumor cells and non-neoplastic follicular cells were negative for CD5. The MIB-1 index was 36%. DNA extracted from the tumor identified a BRAF V600E mutation in exon 15 and a BRAF G468A mutation in exon 11, whereas DNA from non-tumorous cells did not contain a mutation. These molecular findings may suggest a direct transformation from papillary carcinoma to SCC-T.
Combined therapy for thyroid squamous cell carcinoma.
De Vos Filip Yves F L,Sewnaik Aniel,de Wilt J Hans W,Smid Ernst J,den Bakker Michael A,van Meerten Esther
Head & neck
BACKGROUND.: Squamous carcinoma of the thyroid is a rare aggressive disease, resulting in poor prognosis. METHODS AND RESULTS.: We combined cisplatin with paclitaxel on a weekly basis as induction therapy, achieving a high cumulative dose, in a patient with squamous cell tumor of the thyroid with arterial encasement. After surgery, pathologic examination confirmed a complete resection of the primary tumor with clear margins, revealing a successful induction treatment with chemotherapy. CONCLUSIONS.: Our patient now has a recurrence-free survival of >20 months, longer than the mean survival described in the literature.
Clinical trial of weekly paclitaxel chemotherapy for papillary thyroid carcinoma with squamous cell carcinoma component.
Ito Yasuhiro,Higashiyama Takuya,Hirokawa Mitsuyoshi,Fukushima Mitsuhiro,Kihara Minoru,Takamura Yuuki,Kobayashi Kaoru,Miya Akihiro,Miyauchi Akira
Papillary thyroid carcinoma (PC) can occasionally include a squamous cell carcinoma (SCC) component. In this study, we evaluated the effect of weekly paclitaxel chemotherapy in 3 patients with PC including an SCC component. None of these patients had lesions of anaplastic carcinoma on pathological examination. Weekly paclitaxel chemotherapy was performed as an induction chemotherapy for 2 patients. All 3 patients underwent locally curative surgery and weekly paclitaxel chemotherapy after surgery as an adjuvant therapy. The response to the chemotherapy was evaluated based on the RECIST guideline (version 1.1). Two patients had partial responses (PRs) and the remaining 1 had stable disease (SD). The response rate was 67% and the clinical benefit rate (PR+SD) was 100%. One patient died of the growth of lung metastases that had been detected before surgery 22 months after the diagnosis. The remaining 2 are still alive, 14 and 22 months after the diagnosis, respectively. Taken together, weekly paclitaxel may be one of the effective adjuvant therapies for PC with an SCC component.
Mixed squamous cell carcinoma and follicular carcinoma of the thyroid gland.
Mercante Giuseppe,Marchesi Alessandro,Covello Renato,Dainese Linda,Spriano Giuseppe
Auris, nasus, larynx
Primary squamous cell carcinoma of the thyroid gland (PSCCT) is rare and its aetiology is debated. A 67-year-old man presented with neck mass. Fine-needle-aspiration (FNA) cytology and through-cut biopsy were suggestive of poorly differentiated or anaplastic carcinoma. The patient was offered tracheostomy and palliative cure for unresectable tumor of the thyroid; he refused and decided for other opinion. Lobe-isthmusectomy was performed with diagnostic and debulking intent. Final pathology report was of mixed squamous cell and follicular carcinoma of the thyroid. The tumor was a PSCCT. The patient underwent adjuvant chemoradiotherapy. After 2 years, an iliac crest metastasis of follicular carcinoma was diagnosed. The patient is disease free, after surgery and radio-active-iodine treatment. The hypothesis of squamous cell carcinoma transformation from well differentiated thyroid cancer has to be considered in case of PSCCT. Primary squamous cell carcinoma of the thyroid gland (PSCCT) is rare [1-3]; different theories on its aetiology do exist [4-6]. Mixed squamous cell and follicular carcinoma is even more rare than pure squamous cell of the thyroid gland and only few cases are reported in literature . Preoperative diagnosis can be very challenging and the differential diagnosis with secondary squamous cell carcinoma of the thyroid (SSCCT) is manadatory in order to plan a correct management of the disease. The presence of PSCCT with distant metastasis of follicular carcinoma supports the histogenesis of squamous cell carcinomas arising from follicular epithelial cells.
De-differentiation of papillary thyroid carcinoma into squamous cell carcinoma. A case of coexistence within an excised neck lesion.
Evans William David George
BMJ case reports
An 80-year-old man with papillary thyroid carcinoma of the neck underwent surgery and radioiodide therapy. He presented 11 years later with a lesion adjudged from fine needle aspiration to be a squamous cell carcinoma (SCC). Histological analysis of the excised mass revealed a lymph node overwhelmed with papillary thyroid carcinoma and moderately differentiated SCC thought to have transformed from papillary cells. A very small number of similar transformations specifically involving the 'tall cell variant' of papillary carcinoma transforming to spindle cell carcinoma have been reported previously. This case report demonstrates clear images of this rare occurrence and briefly considers factors leading to de-differentiation. The clinician should consider possible transformation from papillary thyroid cancer in cases of SCC of the head and neck as this variation may be more aggressive.
[Primary squamous cell carcinoma of the thyroid: retrospective analysis of 28 cases].
Zhang Yong-xia,Zhang Bin,Wu Yue-huang,Liu Wen-sheng,Liu Shao-yan,Gao Li,Xu Zhen-gang,Tang Ping-zhang
Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery
OBJECTIVE:To investigate the clinicopathological features, treatment outcomes and prognosis of patients with squamous cell carcinoma of the thyroid (SCCT). METHODS:Retrospective review of SCCT cases in our hospital from January 1999 to May 2012. Demographic data and clinical charts, including presenting symptoms, histologic grade of tumor, treatment, and outcome of 28 consecutive patients were obtained. Survival rates and prognostic factors were calculated with SPSS 13.0 software using the Kaplan-Meier method and multivariate Cox model survival analysis. RESULTS:SCCT accounted for only 0.36% of all types of thyroid malignancy. There were 15 males and 13 females, and the median age was 63 years. The presenting symptoms were neck masses (26/28) and hoarse voice (18/28). The 28 SCCTs included 15 high grade tumors, eight intermediate grade tumors and five low grade tumors. According to the UICC 2002 staging criteria, 16 patients were stage IVa, and 12 were stage IVb. Of the 28 patients, 19 underwent surgery plus postoperative radiotherapy, seven underwent surgery alone, and two received radiotherapy alone. The rates of lymph node metastasis and distant metastasis were 60.7% and 25.0%, respectively. The 1-year, 2-year and 5-year overall survival (OS) rate were 50.4%, 25.8% and 19.3%, respectively, and the median overall survival time was 12.2 months. Kaplan-Meier univariate survival analyses indicated that the sizes of the tumors, esophageal invasions and treatment policies are prognostic factors, and multivariate Cox model survival analyses confirmed that the sizes of the tumors and treatment policies were independent factors for OS. Multivariate survival analyses confirmed that the sizes of the tumors and treatment policies were independent factors for OS. CONCLUSIONS:SCCT is a rare malignant tumor with strong invasive ability, high malignancy and poor prognosis. Combined modality therapy was strongly recommended, and surgical resection plus postoperative radiotherapy may be the main treatment protocol for patients with SCCT.
Primary squamous cell carcinoma of the thyroid gland.
Sapalidis Konstantinos,Anastasiadis Iraklis,Panteli Nicolas,Strati Titika-Marina,Liavas Lazaros,Poulios Christos,Kanellos Ioannis
Journal of surgical case reports
Primary squamous cell carcinoma (SCC) of the thyroid gland is a very rare entity representing <1% of all primary carcinomas of the thyroid gland with a very poor prognosis. We report a rare case of a 65-year-old woman with SCC of the thyroid gland, emphasizing the postoperative complications and poor prognosis of these patients. Surgical excision of primary SCC of the thyroid gland when possible is the optimal therapy. Chemo- and radiotherapy rarely have place in its treatment as this malignancy has a poor response to chemotherapy and in many cases is radio-resistant. Median survival of these patients is around 6 months.
Diagnostic significance of PAX8 in thyroid squamous cell carcinoma.
Suzuki Ayana,Hirokawa Mitsuyoshi,Takada Nami,Higuchi Miyoko,Yamao Naoki,Kuma Seiji,Daa Tsutomu,Miyauchi Akira
Most types of thyroid carcinomas express PAX8 transcription factor; however, whether thyroid squamous cell carcinoma (SCC) also expresses PAX8, currently remains unknown. We herein examined the immunoreactivity of PAX8 in SCC of thyroidal and extrathyroidal origin, and discussed the diagnostic significance of PAX8. We immunohistochemically examined specimens from 11 SCC, 22 papillary thyroid carcinoma (PTC), 8 anaplastic thyroid carcinoma (ATC), and 2 mucoepidermoid carcinoma (MEC) cases as well as 5 uterine cervical SCC, 5 esophageal SCC, and 5 pulmonary SCC cases. The rates of PAX8-positive SCC, PTC, ATC, and MEC were 90.9%, 90.9%, 75.0%, and 100%, respectively. Two PAX8-negative PTC cases were cribriform variants. No uterine cervical, esophageal, or pulmonary SCC specimen reacted with PAX8 antibody. Thyroid transcription factor-1 (TTF-1) was positive in 9.1% and 95.5% of SCC and PTC cases, respectively, but negative in all ATC and MEC cases. These results demonstrate that PAX8 staining is useful for distinguishing between primary thyroid SCC and invasion or metastasis from extrathyroidal SCC. We recommend using an immunohistochemical panel of antibodies to PAX8 and TTF-1 to confirm a diagnosis of primary thyroid carcinoma.
Primary Squamous Cell Carcinoma of Thyroid: A Rare Entity.
Chavan Rahulkumar N,Chikkala Bhargav,Biswas Cinjini,Biswas Somak,Sarkar Diptendra Kumar
Case reports in pathology
Primary squamous cell carcinoma (PSCC) of thyroid is an extremely rare malignancy of thyroid. Herewith, we describe a case report of female patient who presented with neck swelling; FNAC misdiagnosed it as papillary carcinoma of thyroid but, after resection, biopsy revealed it to be a case of squamous cell carcinoma of thyroid. After extensive investigations no possible primary focus of squamous cell carcinoma was found elsewhere, so diagnosis of primary squamous cell carcinoma of thyroid was made. Patient underwent chemoradiation but still patient succumbed to death within a year.
Pseudolaric acid B inhibits proliferation in SW579 human thyroid squamous cell carcinoma.
Yu Jinghua,Ren Peiyou,Zhong Ting,Wang Yalin,Yan Minghui,Xue Bianbian,Li Rui,Dai Chunyan,Liu Chunyu,Chen Guang,Yu Xiao-Fang
Molecular medicine reports
Primary squamous cell carcinoma of the thyroid is a rare and aggressive type of neoplasm, which is routinely treated with surgery; however, despite this, survival time is not commonly more than six months. Thus, the aim of the present study was to determine the efficacy of pseudolaric acid (PAB) as a therapeutic agent. PAB is an antitubulin agent, and in the present study, inhibition of the SW579 thyroid squamous cell carcinoma cell line by PAB was investigated. PAB was found to inhibit SW579 cell growth in a time‑ and dose‑dependent manner via interference in α‑tubulin polymerization. However, the inhibitory role of PAB in SW579 cells was not predominantly due to apoptosis, but was due to the cytostatic status resulting from cell cycle arrest. The present study proposes that this is the underlying mechanism of the antitumor properties of PAB. During cytostatis, autophagy was activated to sustain cell survival and SW579 cell migration was inhibited. Nuclear p53 expression was observed to be reduced, however the role of reduced p53 requires further investigation. Therefore, PAB induced cytostasis, which inhibited SW579 cell growth and therefore may function as an antitubulin therapeutic agent.
Metastatic Collision Tumour (Papillary Thyroid Carcinoma and Squamous Cell Carcinoma) in Cervical Lymph Nodes: An Immunohistochemical Analysis.
Alhanafy Alshimaa Mahmoud,Al-Sharaky Dalia,Abdou Asmaa Gaber,Abdallah Rania Abdallah
Journal of clinical and diagnostic research : JCDR
Collision tumours are a rare entity, in this report, we describe a case of 73-year-old woman presented with a rapid enlargement of left upper cervical lymph node (LN) associated with right thyroid nodular goiter. The histopathological examination of the excised LN showed definite areas of papillary thyroid carcinoma admixed with moderately differentiated squamous cell carcinoma (SCC). Thyroglobulin immunostaining was positive in papillary carcinomatous areas confirming thyroid gland as a source of metastasis. Then the patient underwent total thyroidectomy and neck dissection, which revealed multicentric classic papillary thyroid carcinoma with an absence of squamous differentiation on extensive sampling. The patient received adjuvant radioactive iodine, but the neck swelling was rapidly progressing, ulcerated and infected. Computed tomography (CT) revealed left large cervical amalgamated LN and two metastatic lung nodules, the patient received 2 cycles of chemotherapy and was planned for external beam radiotherapy but she died within 7 months of first presentation. Collision tumours pose a diagnostic as well as therapeutic challenge and carry a rapidly progressive course and a fatal outcome. SCC is considered as a dedifferentiation of papillary thyroid carcinoma, which may appear in metastatic site rather than the primary site.
Squamous Cell Carcinoma of the Thyroid as a Result of Anaplastic Transformation from BRAF-Positive Papillary Thyroid Cancer.
Basnet Alina,Pandita Aakriti,Fullmer Joseph,Sivapiragasam Abirami
Case reports in oncological medicine
Papillary thyroid carcinoma (PTC) is the most common malignant neoplasm of the thyroid. Majority of the PTC carries an excellent prognosis. However, patients with tall cell variant (TCV) of papillary thyroid carcinoma have a worse prognosis than those with the classic variant. On the other hand, squamous cell carcinoma of the thyroid (SCT) is an unusual neoplasm thought to arise as a primary tumor or as a component of an anaplastic or undifferentiated carcinoma. We report a patient with TCV of PTC presenting years later with squamous transformation. In addition, the patient was found to have BRAF mutation. Such dedifferentiation is considered to be a rare phenomenon and has been reported only in the form of case reports in the literature. The relationship between BRAFV600E mutation and squamous cell transformation of papillary thyroid cancer is unknown at this time. Meticulous pathology is needed to identify such variants. Our patient responded to treatment with concurrent chemotherapy with carboplatin and paclitaxel along with radiation.
Squamous Cell Differentiation in Metastatic Papillary Thyroid Carcinoma: Metaplastic Reversion or Progression?
Iranian journal of pathology
Squamous cell differentiation (SCD) may occur in papillary thyroid carcinoma (PTC) only at metastatic sites. We have studied cytokeratin CK5/6 and P63 along with TTF1 (thyroid transcription factor 1) and B-Raf (V-Raf murine sarcoma viral oncogene homolog B1) immunohistochemical expression in neck lymph node metastases of thyroid PTC showing SCD. The patient (21-years) presented with a neck mass. The check-up revealed bilateral thyroid nodules. Total thyroidectomy and neck lymph node dissection were performed. The diagnosis was that of bilateral PTC with lymph node metastases (pT-1N1Mx). The metastases were peculiar by the presence of cystic change and of SCD. The thyroid PTC expressed P63 focally and, TTF1 and B-Raf diffusely. Cytokeratin 5/6 was expressed only in the lymph node metastases, in the metastatic cyst lining and in the SCD foci. The P63+ cells outnumbered those CK5/6+. TTF1 expression was faint in SCD. Metastatic, both classical PTCand SCD-epithelia expressed B-Raf. The expression patterns of CK5/6, P63, TTF1 suggest a luminal/central-to-abluminal/peripheral direction for SCD development from PTC-epithelia in lymph node metastases. Whether this metaplasia type may reflect a regression to a less aggressive morphotype or a progression-switch to squamous cell carcinoma-type differentiation in a composite tumor remains matter of debate.
A rare case of ectopic papillary thyroid carcinoma transformed into squamous cell carcinoma.
Yasuoka Hironao,Nakamura Yasushi,Yoshida Ken-Ichi,Shimo Toshiro,Tori Masayuki,Matsui Yuuki,Sakamaki Yasushi,Tsujimoto Masahiko
A rare case of a metastatic ectopic papillary thyroid carcinoma (PTC) of the lung that transformed into a squamous cell carcinoma (SCC) that resembles pulmonary SCC is reported. A subcutaneous ectopic PTC in the left anterior neck area, together with a normal thyroid gland, were excised. The ectopic PTC showed thyroglobulin, TTF-1 and PAX-8 immunoreactivity and a BRAF V600E mutation. During the post-operative follow-up period, a rapidly growing 2 cm nodular lesion in the lower left lobe of the lung was detected. The lung tumor consisted of solid sheets and nests of squamous cells but without the nuclear features of PTC. Neither papillary nor follicular structures of cancer cells were identified. Carcinoma cells were positive for TTF-1, PAX-8, p40, CK14, and p63, while showing a high Ki-67 labeling index and a BRAF V600E mutation. These results support our interpretation of a PTC that originated from ectopic thyroid tissue in the left anterior neck and that developed a lung metastasis showing squamous cell differentiation.
Immunohistochemical Features of Primary Pure Squamous Cell Carcinoma in the Thyroid: An Autopsy Case.
Koyama Satoshi,Fujiwara Kazunori,Nosaka Kanae,Fukuhara Takahiro,Morisaki Tsuyoshi,Miyake Naritomo,Kitano Hiroya,Takeuchi Hiromi
Case reports in oncology
Primary squamous cell carcinoma (SCC) in the thyroid is extremely rare and has been reported in < 1% of all thyroid cancer cases. Primary SCC in the thyroid was thought to be a transitional form derived from adenocarcinomas; therefore, the majority of reported cases have focused on the conjunction with other histological adenocarcinomas. A 73-year-old male presented to our hospital with bilateral vocal fold palsy and an anterior neck mass. Ultrasound sonography revealed a bulky tumor in the thyroid and bilateral cervical lymphadenopathy. We performed fine-needle aspiration cytology from the thyroid tumor, which revealed SCC. Positron emission tomography/computed tomography showed distant metastases in the lungs, mediastinal lymph nodes, and vertebra. We diagnosed the patient as having stage IVC SCC in the thyroid and administered weekly paclitaxel. Four and a half months after treatment initiation, the tumor progression resulted in aspiration pneumonia, which proved fatal. We performed an autopsy in accordance with the patient's wishes. Pathological findings revealed that all carcinomas in the thyroid, cervical lymph nodes, and lungs were pure SCCs. Immunohistochemical examinations for PAX8, thyroglobulin, and TTF-1 were all negative. Differentiated thyroid carcinomas have 3 major positive markers - PAX8, thyroglobulin, and TTF-1 -, and PAX8 is also sometimes positive for SCC in the thyroid. PAX8 positivity of SCC in the thyroid might, however, be associated with conjunction with other histological adenocarcinomas such as papillary or follicular thyroid carcinoma; therefore, pure SCC in the thyroid might be negative for PAX8.
Primary squamous cell carcinoma of the thyroid associated with papillary thyroid carcinoma and Hashimoto's thyroiditis.
Kallel S,Kallel R,Ayadi S,Ghorbel A
European annals of otorhinolaryngology, head and neck diseases
INTRODUCTION:We report the first case of squamous cell carcinoma (SCC) of the thyroid gland coexisting with papillary thyroid carcinoma (PTC) and Hashimoto's thyroiditis and discuss various theories concerning the histogenesis of SCC of the thyroid gland and the optimal treatment strategy. CASE REPORT:A 54-year-old woman presented with an anterior neck mass measuring 4cm on clinical examination. Imaging showed a suspicious thyroid nodule invading the trachea. Total thyroidectomy with bilateral central lymph node resection was performed. Histological examination revealed tall cell variant of papillary thyroid carcinoma associated with SCC of the right lobe of the thyroid and Hashimoto's thyroiditis. Immunohistochemistry of the SCC showed positive staining for p53 and Ki67 and negative staining for thyroglobulin. The patient underwent adjuvant radioactive iodine therapy and radiotherapy. With postoperative follow-up of 24 months, the patient was in good health. DISCUSSION:In conclusion, the most probable origin of SCC in this case was malignant transformation from Hashimoto's thyroiditis following a phase of metaplasia. This immunohistological profile is associated with a better prognosis. Optimal treatment consists of extensive surgical resection of tumour tissuefollowed by radiotherapy.
[Effects of genistein on proliferation and invasion of human thyroid squamous cell carcinoma SW579 cells].
Zhao Dan,Yin Jianzhong,Wu Shaoxiong,Wu Zhishuang,Pan Hongmei
Wei sheng yan jiu = Journal of hygiene research
OBJECTIVE:To study the effect and mechanism of genistein on the proliferation, adhesion, invasion and migration of SW579 cells. METHODS:MTT assay was used to detect the effect of genistein on cell proliferation of the thyroid carcinoma cell line( SW579). Cell-matrix adhesion and transwell invasion assay were used to measure the impact of genistein on the cell adhesion, invasion and migration. Real-time PCR assay was used to detect the effect of genistein on the level of MMP2 mRNA. RESULTS:Compared with the control groups, genistein treated groups can significantly promote the proliferation of SW579 cells. However, genistein can obiviously inhibited the adhesion, invasion and migartion of SW579 cells. And genistein can dramatically decreased MMP2 mRNA expression in SW579 cells. CONCLUSION:In the study, genistein could effectively inhibit the invasion and migration ability of the SW579 cells in vitro, and the reduction of MMP-2 expression may play an important role in this process.
Total thyroidectomy associated to chemotherapy in primary squamous cell carcinoma of the thyroid.
De Cesare A,Di Cristofano C,Di Filippo A R,Salesi N,Spaziani M,Picchio M,Spaziani E
La Clinica terapeutica
Primary squamous cell carcinoma of the thyroid (PSCCT) is a rare malignant disease with rapid fatal prognosis. The onset is generally characterized by sudden bilateral latero-cervical lymphadenopathy. The Authors report patient of 58-year-old who referred for evaluation of rapidly aggravating bilateral latero-cervical lymphadenopathy. The US highlighted the presence of a hypoechoic nodular lesion characterized by peri and intra-nodular vascularization. Multilayer CT showed diffused involvement of mediastinal and bilateral latero-cervical lymph nodes, with no evidence of primary pulmonary neoplasia or elsewhere. The patient underwent total thyroidectomy. The peri-isthmic tissue was removed due to the presence of a small roundish formation, that was due to lymph node metastasis at histological examination. Histological diagnosis: PSCCT. The immunohistochemical panel of the thyroid lesion was indispensable for the differential diagnosis between PSCCT, medullary carcinoma, anaplastic carcinoma, and thyroid metastasis of neoplasia with unknown primitiveness. The patient underwent chemotherapeutic treatment with Carboplatin and Paclitaxel with modest improvement of dysphagia symptoms and reduction of 10-15% of the target lesions. The clinical course was characterized by loco-regional progression of the disease with exitus in 10 months after diagnosis. Survival and quality of life after surgical therapy and chemotherapy were like that of patients undergoing only chemotherapy. Due to the extreme rarity of the neoplasia, 60 cases described in Literature, no exclusive guidelines are reported for PSCCT. More extensive case studies are needed to evaluate the effects of total thyroidectomy with intent R0/R1 on improving survival and quality of life of patients with PSCCT.
Primary Squamous Cell Carcinoma of the Thyroid.
Raggio Blake,Barr Jeremy,Ghandour Zahraa,Friedlander Paul
The Ochsner journal
Primary squamous cell carcinoma of the thyroid (PSCCT) is a rare malignancy of the head and neck, with fewer than 60 cases reported in the literature. We report a case of PSCCT and provide a brief review of the literature. A 66-year-old female with a history of a hemithyroidectomy for a benign thyroid lesion presented with 3 months of progressively worsening compressive symptoms and shortness of breath. Physical examination revealed right-sided thyromegaly and right-sided true vocal fold immobility. Preoperative imaging with ultrasound and computed tomography scan confirmed an enlarged right thyroid, as well as right anterior cervical lymphadenopathy, subglottic stenosis, and bilateral pulmonary nodules. Fine needle aspiration of the thyroid was suggestive of carcinoma. Intraoperative findings of gross tracheal invasion during a planned completion thyroidectomy prompted limited resection and impromptu tracheotomy. Histopathologic and immunohistochemical evaluation confirmed a squamous cell carcinoma of thyroid origin. Further oncologic workup with core lung biopsy and positron emission tomography scan demonstrated metastasis to the lung and cervical spine. Palliative chemotherapy was begun, but the patient died 1 week into therapy. PSCCT is a rare but aggressive malignancy of the head and neck. Histopathologic and immunohistochemical evaluations are essential for diagnosis. While locoregional surgery and radiation therapy may improve the length of survival, the prognosis of patients with PSCCT is poor. Physicians should be mindful of this unique but deadly disease process, as early diagnosis and rapid treatment initiation are essential to optimize treatment outcomes.
Primary thyroid squamous cell carcinoma - a Scottish National Case Series.
Lim Alison E,Sooby Paul,Townsley Richard B
Scottish medical journal
AIM:To present our national case series on primary thyroid squamous cell carcinoma (PTSCC) and add to the current literature about this rare and aggressive disease. METHODS:Scottish pathology departments were contacted and asked to provide details of patients with the diagnosis of PTSCC from the last 10 years. Three patients were included. RESULTS:Patients 1, 2 and 3 underwent surgical resection. Patients 1 and 3 went on to receive chemoradiotherapy. Patient 1 received nivolumab. Patient 1 died 10 months following diagnosis. Patient 2 and 3 are currently living with no recurrence, over two years post-diagnosis. CONCLUSION:This case series has demonstrated an unusually good set of outcomes for a classically rapidly progressing disease with poor survival rates. This raises the question whether there is a subgroup of PTSCC associated with better outcomes and lower mortality. A patient-centred approach will give optimal patient management.
A case report of papillary thyroid carcinoma dedifferentiated to squamous cell carcinoma presenting as a lung metastasis: A potential diagnostic pitfall.
Gadde Ramya,Tafe Laura J,Tsapakos Michael J,Liu Xiaoying
Papillary thyroid carcinoma (PTC) tall cell variant (TCV) with squamous dedifferentiation is a rare entity. We present a case of 90-year-old woman who initially had a 2.8 cm conventional PTC in right lobe of thyroid who, couple decades later, had metastatic dedifferentiated PTC to right neck lymph nodes level II and IV with tall cell features; to right level IV and V lymph nodes with tall cell and squamous components, which recently presented exclusively as squamous cell carcinoma (SCC) metastasizing to lung. The squamous component in the lymph node and SCC in the lung were both positive for squamous marker p63 and PTC markers TTF1, PAX-8 and BRAF V600E while negative for thyroglobulin and p16. The papillary component was positive for TTF-1, BRAF V600E and P63 (majority); negative for thyroglobulin and p16. Final diagnoses were rendered based on combination of cytological features and immunohistochemical profiles. This report highlights the utilization of current biomarkers to distinguish between metastatic dedifferentiated PTC with squamous features and primary lung SCC, as well as the importance of recognizing this rare entity.
Effect of a second primary thyroid carcinoma on patients with head and neck squamous cell carcinoma.
Tolisano Anthony M,Klem Christopher,Lustik Michael B,Sniezek Joseph C,Golden J Blake
Head & neck
BACKGROUND:The purpose of this study was to characterize the timing, histology, and behavior of second primary thyroid carcinoma (SPTC) developing after a diagnosis of head and neck squamous cell carcinoma (HNSCC). METHODS:We conducted a retrospective review of the Surveillance, Epidemiology, and End Results (SEER) 9 database. RESULTS:Patients with HNSCC who develop SPTC die 1.6 times sooner than those without SPTC. This effect is only seen if SPTC presents >6 months after diagnosis of HNSCC. Models were adjusted for age, sex, year of diagnosis, and location of HNSCC. There was no effect of prior radiation therapy on either mortality rates or time to development of thyroid cancer in patients with SPTC. The type of thyroid carcinoma that developed was similar between cohorts. CONCLUSION:The development of SPTC in patients with HNSCC results in decreased overall length of survival. © 2015 Wiley Periodicals, Inc. Head Neck 38: E890-E894, 2016.
Primary squamous cell of the thyroid-an abbreviated clinical presentation.
Lui Justin T,Khalil Moosa N,Chandarana Shamir P
Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale
BACKGROUND:Lacking any squamous epithelium, thyroid gland with primary squamous cell carcinoma (PSCC) proves to be an etiopathophysiological quandary. Two major theories do exist, though few cases have been documented to support either. We present a case that supports the "metaplasia" theory, which serves to enhance our understanding of a disease that carries with it a very poor prognosis. CASE PRESENTATION:We present a case of an extremely advanced, primary squamous cell carcinoma of the thyroid with distant metastases in a thirty-six year-old male. Dying of airway compromise seventeen days following his admission, this is the shortest median survival of all documented cases. CONCLUSION:In addition to being the most abbreviated time period between presentation and death of all documented thyroid primary squamous cell carcinomas, we share the fifth case of thyroid PSCC in the setting of lymphocytic thyroiditis. This case should build awareness of the aggressivity of the disease and the lack of established diagnostic criteria.
Primary squamous cell carcinoma of the thyroid. Initial assessment and follow-up using F-FDG PET/CT.
Caballero Gullón L,Carmona González E,Martínez Estévez A,Gómez Camarero M P,Corral J J,Borrego Dorado I
Revista espanola de medicina nuclear e imagen molecular
Squamous cell carcinoma of thyroid is an uncommon, very aggressive neoplasm, having a poor prognosis and poor response to chemotherapy and radiotherapy. Surgery is the initial treatment of choice, although it often presents as a widespread disease at the time of diagnosis, usually with cervical swelling that causes most of the symptoms due to local infiltration or metastasis. Local infiltration from adjacent tumour and metastatic disease needs to be excluded from other primary epidermoid carcinomas, in order to make a correct diagnosis. This also requires the typical cytokeratin pattern seen in histological studies. The case is presented of a 53 year-old man with a medical history of hepatocarcinoma, with a cervical hypermetabolic lesion detected in an F-FDG PET/CT performed to exclude widespread disease. The follow-up of this lesion with this technique and its usefulness is also described.
A Primary Squamous Cell Carcinoma of the Thyroid Presenting as the Anaplastic Thyroid Carcinoma: A Case Report.
Zheng Rui-Zhe,Huang Guo-Hui,Xu Ying-Jie
Frontiers in surgery
Primary squamous cell carcinoma of the thyroid (PSCCT) is an uncommon malignancy that is difficult to diagnose and differentiate. There is no consensus for the early clinical, radiological, or ultrasonic identification of PSCCT before pathological changes are observed in patients. There is also no suitable treatment due to the absence of a definite diagnosis. A 76-year-old female patient complained about a rapidly growing cervical mass, dyspnea, dysphagia, and a change in her voice. Based on the results of thyroid ultrasound, fine-needle aspiration, and plain and enhanced CT, the patient was initially diagnosed with anaplastic thyroid carcinoma (ATC). Thereafter, we removed the mass that was the patient's main complaint. The gross examination of the patient's symptoms also supported our previous diagnosis. However, her disease was finally diagnosed as PSCCT, according to the histopathology and immunohistochemistry findings of the mass. Our case highlights the need for a comprehensive framework in the management of PSCCT. The more auxiliary examinations (e.g., ultrasonographic, radiology, or biopsy examinations) we take, the more likely we are to identify this disease. Immunohistochemistry is currently the preferred examination for the diagnosis of PSCCT, while surgical resection combined with radio-sensitizing therapy and adjuvant chemotherapy is the main treatment method for PSCCT.
Primary squamous-cell thyroid carcinoma - a successful treatment with five-year follow-up.
Wygoda Andrzej,Rutkowski Tomasz,Szcześniak-Kłusek Bogna,Mrochem-Kwarciak Jolanta,Jędrzejewska Maja,Składowski Krzysztof
Squamous cell carcinoma is an extremely rare neoplasm of the thyroid (SCTC) that represents no more than 1% of all primary thyroid malignancies. We report a case of a 42-year-old woman with rapidly growing mass in the right lower neck, primarily diagnosed in fineneedle aspiration cytology as a low-differentiated carcinoma. After the surgery, exclusion of all the other possible primary tumour locations, and immunohistochemistry tests, the diagnosis of primary squamous cell carcinoma of the thyroid gland was established. Because of close surgical margins and metastatic neck node, the patient was referred to adjuvant postoperative irradiation. With five-year follow-up the patient is free of disease and still in very good condition.
Contrast-Enhanced Ultrasound of Primary Squamous Cell Carcinoma of the Thyroid: A Case Report.
Chen Sijie,Peng Qinghai,Zhang Qi,Niu Chengcheng
Frontiers in endocrinology
Primary squamous cell carcinoma of the thyroid (ThyPSCC) is an extremely rare aggressive malignancy with a poor prognosis. However, almost no report thus far has investigated the microvasculature of ThyPSCC imaged using contrast-enhanced ultrasound. A 59-year-old male patient presented to our hospital with progressively worsening hoarse voice symptoms for 20 days and was diagnosed with left unilateral vocal fold palsy. Ultrasonography revealed a solitary marked hypoechoic thyroid nodule with an unclear boundary in the inferior part of the left lobe. Color Doppler flow imaging showed a poor blood flow signal inside this nodule. Contrast-enhanced ultrasound images showed a persistent low peak enhancement of the nodule from its periphery to its center. The time-intensity curve displayed a wash-in time of 10 s, a time to peak of 37 s, a peak signal intensity of 24.5%, and a wash-out time of 70 s for the thyroid tumor. Finally, left hemithyroidectomy of the thyroid tumor was performed, and histopathologic and immunohistochemical evaluations confirmed the diagnosis of ThyPSCC. Postoperatively, the patient received a combination therapy of chemotherapy, radiotherapy, and targeted therapy, but the patient died 4 months after surgery. Primary squamous cell carcinoma of the thyroid is a rare but aggressive malignancy of the thyroid. Herein, we reported a case of ThyPSCC and its ultrasonography and pathologic findings.
Primary squamous cell carcinoma of the thyroid with complete response to radical radiotherapy and concurrent cisplatin-based chemotherapy.
Del Rosario Michael,Dasanu Constantin,Tsai Henry,Johnson Robert
BMJ case reports
Chemoradiotherapy and/or surgery are both potentially radical treatments for squamous cell carcinomas. Squamous cell carcinomas are considered chemosensitive tumours compared to adenocarcinomas or anaplastic thyroid malignancies. A 76-year-old man was found to have T4bN0M0 primary squamous cell carcinoma of the thyroid with encasement of the internal carotid artery. The disease was deemed unresectable. Therefore, he was treated with radical radiotherapy with concurrent cisplatin-based chemotherapy. We discuss herein the aetiology, diagnosis and management of primary squamous cell carcinoma of the thyroid. We demonstrate success of chemoradiotherapy in an unresectable case of a rare and aggressive disease.
Prognostic Characteristics of Primary Squamous Cell Carcinoma of the Thyroid: A National Cancer Database Analysis.
Limberg Jessica,Ullmann Timothy M,Stefanova Dessislava,Finnerty Brendan M,Beninato Toni,Fahey Thomas J,Zarnegar Rasa
World journal of surgery
BACKGROUND:Primary squamous cell carcinoma of the thyroid (ThySCC) is a rare cancer, primarily described only in case reports. We aimed to characterize the prognosis of ThySCC and compare its oncologic behavior to other thyroid malignancies. METHODS:The National Cancer Database was queried to identify patients with ThySCC, papillary, tall cell variant, poorly differentiated (PDTC), and anaplastic (ATC) subtypes of thyroid cancer treated from 2004 to 2015. Demographics, tumor characteristics, and treatments were compared by tumor type and assessed to identify independent predictors of overall survival (OS). RESULTS:Of 123,684 patients included, 314 had ThySCC. ThySCC patients had a 5-year OS of 17.7%, more closely resembling ATC (8.3%) than PDTC or PTC. ThySCC and ATC patients had similar demographics, except ThySCC patients who were younger (68.0 vs. 70.2 years, p < 0.01). ThySCC tumors were smaller (mean 53.5 ± 45.7 vs. 69.5 ± 75.2 mm) with less frequent extrathyroidal extension (ETE) (64.0% vs. 73.8%), lymphovascular invasion (8.3% vs. 12.3%), and positive margins (22.0% vs. 28.3%) compared to ATCs (p < 0.05). ETE [HR 3.1 (95% CI 1.5-6.4), p < 0.05] and lymph node metastases [HR 2.2 (95% CI 1.2-4.0) p < 0.05] were independently associated with worse OS for ThySCC patients. Both ThySCC and ATC patients had similar surgical success rates, with R1 resection possible in 37.3% versus 35.0% of patients, respectively (p < 0.05). However, in contrast to ATC patients, adjuvant therapy was not associated with improved OS for ThySCC patients after complete resection. CONCLUSIONS:ThySCC has a poor prognosis, similar to ATC, but with fewer aggressive features and no apparent survival benefit with adjuvant therapy after complete macroscopic surgical resection.
Primary squamous cell carcinoma of thyroid: a case report and review of literature.
Tunio Mutahir A,Al Asiri Mushabbab,Fagih Mosa,Akasha Rashad
Head & neck oncology
BACKGROUND:Thyroid gland lacks squamous epithelium (except in some rare situations like embroyonic remnants or in inflammatory processes); for that reason the primary squamous cell carcinoma (SCC) of thyroid is extremely rare entity, seen only in less than 1% of all thyroid malignancies and is considered almost fatal. So, far, only few case reports have been published in literature. CASE PRESENTATION:Herein we present a 54 years old Saudi female with 3 months history of progressive neck swelling and hoarse voice, who was referred to us by her primary care physician as suspected case of anaplastic carcinoma of thyroid for radical external beam radiation therapy (EBRT). Fine Needle aspiration cytology (FNAC) revealed squamous cell carcinoma. Computed tomography (CT) neck showed 10 × 10 cm mass in left lobe of thyroid invading trachea and skin. Extensive staging work up ruled out the possibility of any primary site of SCC other than thyroid gland. Tumor was found unresectable and was referred to radiation oncology. She received palliative EBRT 30 Gy in 10 fractions. After completion of EBRT, there was progression of disease and patient died 3 months after completion of EBRT by airway compromise. CONCLUSION:Primary SCC of thyroid is rare and aggressive entity. FNAC is reliable and effective tool for immediate diagnosis. Surgery is a curative option, but it is not always possible as most of cases present as locally advanced with adjacent organs involvement. EBRT alone was found ineffective. Aggressive combined modality (debulking surgery, radiation and chemotherapy) shall be considered for such cases.
The treatment and outcome analysis of primary squamous cell carcinoma of the thyroid.
Yasumatsu Ryuji,Sato Masanobu,Uchi Ryutaro,Nakano Takafumi,Hashimoto Kazuki,Kogo Ryunosuke,Taura Masahiko,Matsuo Mioko,Nakashima Torahiko,Nakagawa Takashi
Auris, nasus, larynx
OBJECTIVES:Primary squamous cell carcinoma (SCC) of the thyroid is a rare disease. It usually presents with locally advanced disease and has an overall poor prognosis. In this study, we investigated the characteristics and outcomes of patients with SCC of the thyroid, and reported our experience with chemotherapy with lenvatinib in the treatment of SCC of the thyroid. METHODS:The management outcome of 10 patients who had SCC of the thyroid between January 2000 and 2015 at Kyushu University Hospital or associated facilities was reviewed. RESULTS:There were 3 males and 7 females, ranging in age from 53 to 77 years. Extent of disease was staged as follows: stage IVA, 3 cases; stage IVB, 3 cases; stage IVC, 4 cases. Only tracheostomy was applied for 2 cases, surgical resection, such as total thyroidectomy and neck dissection, for the other 8 cases. Radiotherapy following surgical treatment was applied for 9 cases. Four patients started on oral lenvatinib due to recurrent or progressive SCC of the thyroid. The one year actuarial survival rate of patients was 22.7%. There was no 2-year survivor of all patients. CONCLUSIONS:Treatment should primarily be targeted at surgical resection with negative margins in patients with resectable disease. Lenvatinib may show promise to potentially extend survival.
Primary Squamous Cell Carcinoma of Thyroid - A Rare Malignant Goitre.
Shenoy Vijendra S,Rao Raghavendra A,Kamath Panduranga M,Prasad Vishnu,Haseena S
Indian journal of surgical oncology
Primary squamous cell carcinoma of thyroid is a very rare malignant disease because thyroid gland lacks squamous cells. The disease is almost fatal. Only around 60 cases have been reported in literature. Its incidence is less than 1 % of all thyroid malignancies. The overall survival rate is less than 1 year after the diagnosis. Here we report a rare case of a 70 year old lady who presented with sudden increase in the size of swelling associated with pain and obstructive symptoms in long standing thyroid swelling. Considering patient's age and inoperable nature of disease we treated the patient with concurrent chemoradiation.
Treatment optimization and prognostic considerations for primary squamous cell carcinoma of the thyroid.
BACKGROUND:Primary squamous cell carcinoma of the thyroid (PSCCT) is a rare aggressive malignancy that usually presents in an advanced stage and has a poor prognosis. Our study aimed to investigate the clinical characteristics, treatment, and prognosis of PSCCT. METHODS:We retrospectively reviewed the medical information of patients with PSCCT diagnosed from January 2006 to May 2018 at Xiangya Hospital. Survival analysis was conducted using the Kaplan-Meier method, and Log-Rank tests were performed for statistical testing. RESULTS:We identified 12 patients with PSCCT (nine males and three females), accounting for only 0.19% of all thyroid cancer diagnosed during this time period. The median age of these patients was 59.5 years old and their symptoms included neck masses (n=5), hoarseness (n=2), dyspnea (n=1), dysphagia (n=1) and neck pain (n=1). Four patients were in stage IVA, five were stage IVB, and three patients were stage IVC. Six patients underwent comprehensive treatment (surgery + radiotherapy or surgery + radiotherapy + chemotherapy) and the remaining patients received radiotherapy and/or chemotherapy. The 6-month survival rate was 66.7%, compared to a 1-year survival rate of 25.0%, with a median overall survival time was 10.5 months. Kaplan-Meier analysis showed that the comprehensive treatment was superior to radiotherapy and/or chemotherapy (P=0.003). CONCLUSIONS:PSCCT is a rare type of thyroid cancer that is highly invasive and has a poor prognosis. We show that a comprehensive treatment plan can significantly improve patient survival.
Collision tumor of the thyroid gland: primary squamous cell and papillary thyroid carcinoma.
Warman Meir,Lipschitz Noga,Ikher Sergey,Halperin Doron
Introduction. Collision tumor of the thyroid gland is defined when independent and histologically distinct tumors coexist within the gland. The presence of both papillary and squamous cell carcinoma in the thyroid gland is unusual. Suggested etiologies include embryonic remanents of squamous epithelium, chronic inflammation, or thyroid malignancies promoting squamous metaplasia. Case Presentation. An elderly patient presented with a rapid enlargement of a long-standing right thyroid nodule. The tumor was locally invasive and unresectable. Pathology revealed the diagnosis of papillary and squamous cell carcinoma of the thyroid gland. Possible primary sites for squamous cell carcinoma in upper aerodigestive tract were excluded. The patient outcome was fatal although palliative chemoradiotherapy. Discussion. Collision tumor of papillary and squamous cell carcinoma of the thyroid gland is a rare entity that may imply bad prognosis, as to the presence of the squamous portion. The best treatment includes resection of the tumor; unfortunately it is not possible in most cases.
Primary squamous cell carcinoma of the thyroid: Case report and systematic review of the literature.
Struller Florian,Senne Moritz,Falch Claudius,Kirschniak Andreas,Konigsrainer Alfred,Muller Sven
International journal of surgery case reports
BACKGROUND:Primary squamous cell cancer (PSCC) of thyroid is a rare malignancy with poor prognosis. It is mandatory to exclude secondary involvement of the thyroid by panendoscopy, CT-scan and immunohistochemical analysis. As treatment surgery, radiation and rarely chemotherapy is employed. METHODS:A systematic review of the literature was conducted searching medline and embase database using the medical subject headings "primary squamous cell carcinoma of thyroid" and "primary squamous cell cancer of thyroid", for articles published until April 2016 (n=1733). Of interest were the used treatment modalities and survival outcomes. RESULTS:A total of 35 publications reporting on 50 cases including ours were finally analyzed. A curative treatment approach was described in 24 patients (48%). Additional radiotherapy, chemotherapy or radiochemotherapy was applied in 17, 7 and 7 patients respectively. Median overall survival was 6 months [range 0-48] for 47 patients. Disease free survival was only achieved in 8 patients with disease limited to the thyroid gland, complete surgical resection and additional radiotherapy or radiochemotherapy [reported median 20 months; range 12-48]. CONCLUSION:Reported disease free survival of PSCC of the thyroid was only achieved in patients with complete surgical resection in combination with adjuvant radio- and/or chemotherapy. However long term survival has not been reported in the literature yet.
Less aggressive disease in patients with primary squamous cell carcinomas of the thyroid gland and coexisting lymphocytic thyroiditis.
Asik Mehmet,Binnetoglu Emine,Sen Hacer,Gunes Fahri,Muratli Asli,Kankaya Duygu,Uysal Fatma,Sahin Mustafa,Ukinc Kubilay
Contemporary oncology (Poznan, Poland)
AIM OF THE STUDY:Primary squamous cell carcinoma (SCC) of the thyroid gland is extremely rare. Infrequently, primary SCC of the thyroid gland is accompanied by other thyroid diseases such as Hashimoto's thyroiditis (HT). Recently, studies have demonstrated that differentiated thyroid cancer with coexisting HT has a better prognosis. However, the prognosis of patients with primary SCC of the thyroid gland and coexistent HT has not been clearly identified. We compared the clinical characteristics and disease stages of patients with primary SCC with and without lymphocytic thyroiditis (LT). MATERIAL AND METHODS:We reviewed reports of primary SCC of the thyroid gland published in the English literature. RESULTS AND CONCLUSIONS:We identified 46 papers that included 17 cases of primary SCC of the thyroid gland with LT and 77 cases of primary SCC of the thyroid gland without LT. Lymph node metastasis and local invasion rates did not differ between these two groups. Distant metastases were absent in patients with LT, and were observed in 13 (16.9%) patients without LT. A greater proportion of patients without LT had advanced stage disease (stage IV A-B-C) than patients with LT (p < 0.05). Patients with primary SCC of the thyroid gland and coexisting LT had lower tumour-node-metastasis stage and frequency of distant metastasis than those without LT. Lymphocytic infiltration in patients with SCC appears to limit tumour growth and distant metastases.
Primary squamous cell carcinomas in the thyroid gland: an individual participant data meta-analysis.
Cho Jae Keun,Woo Seung-Hoon,Park Junoh,Kim Min-Ji,Jeong Han-Sin
Primary squamous cell carcinomas arising from the thyroid gland (SCCTh) is extremely rare diseases, which have never been fully studied. Thus, we performed a systematic review and individual participant data meta-analysis of published SCCTh cases, to understand the clinical characteristics and to identify the prognostic factors of primary SCCTh. A literature search was conducted within Medline, EMBASE, Cochrane library databases and KoreaMed using the following Medical Subject Headings (MeSH) keywords: "primary," "squamous," "carcinoma," "cancer," and "thyroid." Eighty-four patients' individual data from 39 articles and five patients' data in our institute were selected for analysis (N = 89). The mean age at diagnosis was 63.0 years (range, 24-90) and female preponderance (M:F = 1:2) was noted. The commonest complaint was the anterior neck mass, followed by dyspnea or dysphagia, and extension to the adjacent structure was found in 72%. The median survival was 9.0 months (95% CI, 6.0-23.0) and 3-year survival rate (3YSR) was 37.6% by Kaplan-Meier method, but only 20.1% by a shared frailty model for adjusting heterogeneity. Complete resection (R0) of tumors was the only significant prognostic factor in multivariable analysis, and the benefit of adjuvant treatment was not proved. The prognosis of patients with SCCTh is very poor (20% in 3YSR), but complete resection of disease is correlated with improved survival. To achieve complete surgical eradication of tumors, early detection and accurate diagnosis should be emphasized.
Primary squamous cell carcinoma of thyroid gland with local recurrence: ultrasonographic and computed tomographic findings.
Jang Ja Yoon,Kwon Kye Won,Kim Sang Wook,Youn Inyoung
Ultrasonography (Seoul, Korea)
Primary squamous cell carcinoma of the thyroid gland (PSCCT) is a rare malignancy that presents with advanced disease and poor prognosis. It is difficult to diagnose PSCCT in its early stage because of its rarity and lack of typical imaging findings. We experienced an elderly woman with PSCCT confirmed by surgery. Although preoperative fine-needle aspiration revealed no malignancy, surgical resection was performed because the ultrasonogram showed diffuse microcalcifications, which suggested malignancy, and clinically, the mass grew rapidly to compress the trachea. Local tumor recurrence was noted at 3 months after surgery. Surgical resection or repeat biopsy should be considered if a cytologically benign thyroid mass shows imaging or clinical features of malignancy.
Primary Squamous Cell Carcinoma of the Thyroid: A Population-Based Analysis.
Au Joshua K,Alonso Jose,Kuan Edward C,Arshi Armin,St John Maie A
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
Objectives To analyze the epidemiology and describe the prognostic indicators of patients with primary squamous cell carcinoma of the thyroid. Study Design and Setting Retrospective cohort study based on a national database. Methods The US National Cancer Institute's SEER registry (Surveillance, Epidemiology, and End Results) was reviewed for patients with primary squamous cell carcinoma of the thyroid from 1973 to 2012. Study variables included age, sex, race, tumor size, tumor grade, regional and distant metastases, and treatment modality. Survival measures included overall survival (OS) and disease-specific survival (DSS). Results A total of 199 cases of primary squamous cell carcinoma of the thyroid were identified. Mean age at diagnosis was 68.1 years; 58.3% were female; and 79.4% were white. Following diagnosis, 46.3% of patients underwent surgery; 55.7%, radiation therapy; and 45.8%, surgery with radiation therapy. Kaplan-Meier analysis demonstrated OS and DSS of 16% and 21% at 5 years, respectively. Median survival after diagnosis was 9.1 months. Multivariate Cox regression analysis showed that predictors of OS and DSS included age ( P < .001, P < .001, respectively), tumor grade ( P < .001, P = .001), and tumor size ( P < .001, P = .001). Surgical management was a predictor of OS but not DSS. Conclusion Squamous cell carcinoma of the thyroid is a rare malignancy with a very poor prognosis. Surgical resection confers an overall survival benefit. Age, tumor grade, and tumor size are predictors of OS and DSS.
Primary squamous cell carcinoma (PSCC) of the thyroid: a case report and review of the literature.
Sun Bai-Hui,Yu Shi-Tong,Ge Jun-Na,Lei Shang-Tong
Primary squamous cell carcinoma (PSCC) is a rare neoplasm of the thyroid with a very poor prognosis. We report a case of a 42-year-old woman with occasionally found mass in the right anterior area of the neck. After a total thyroidectomy, histopathology and immunohistochemistry tests confirmed primary squamous cell carcinoma of the thyroid with the exclusion of all other possible primary tumor locations. 5 months later, PET scan discovered abnormality in right cervical lymph nodes with a fine needle aspiration confirming to be tumor recurrence. After a modified radical neck dissection was performed with pathological results of the neoplasms being PSCC of the thyroid origin, a full course consecutive radiotherapy was then followed. Due to a prompt diagnosis and the complete dissection of primary tumor and metastatic lymph nodes, no recurrence was observed at the follow-up visits. Comparing to the published cases of PSCC of the thyroid, our paper stated a whole process of diagnosis and standardized treatment, together with classical matched figures of pre-op examinations and dissected specimen. Furthermore, a review of the present literatures summarized the diagnosis, treatment and prognosis of thyroid PSCC. The management of PSCC requires a multi-disciplinary approach.
[Primary squamous cell carcinoma of the thyroid gland].
Kleinhans H,Schmid K W,Verse T
Primary squamous cell carcinoma of the thyroid gland is a rare form of cancer. As part of the differential diagnosis, metastases or direct extension from an extra-thyroidal primary tumor must always be ruled out. We report on a 59-year-old patient presenting with a 3.9-cm cold nodule on thyroid scintigraphy. A total thyroidectomy was performed and the final histopathological evaluation revealed an undifferentiated, primary squamous cell carcinoma of the thyroid gland, tumor stage pT2 pN0 (0/56), L0 V0 R0. On the basis of the R0 resection, tumor size and negative nodal status, we recommended regular postoperative follow-up examinations without adjuvant radiochemotherapy.
Squamous cell carcinoma of the thyroid gland: primary or secondary disease?
Syed M I,Stewart M,Syed S,Dahill S,Adams C,McLellan D R,Clark L J
The Journal of laryngology and otology
OBJECTIVE:To review the aetiopathogenesis, clinical characteristics, immunohistochemical profile, prognosis and treatment options for primary thyroid squamous cell carcinoma, and to compare it with squamous cell carcinoma metastatic to the thyroid, thus providing the reader with a framework for differentiating primary and secondary disease. METHOD:Review of English language literature from the past 25 years. SEARCH STRATEGY:A search of the Medline, Embase and Cochrane databases (April 1984 to April 2009) was undertaken to enable a comprehensive review. RESULTS:After applying strict criteria for the diagnosis of primary thyroid squamous cell carcinoma, 28 articles were identified reporting 84 cases. When reviewing secondary thyroid squamous cell carcinoma, we only analysed cases of squamous cell carcinoma metastatic to the thyroid gland, and found 28 articles reporting 78 cases. CONCLUSION:It is possible to differentiate between primary and secondary thyroid squamous cell carcinoma, on the basis of combined evidence from clinical examination and endoscopic, pathological and radiological evaluation. Such differentiation is important, as the prognosis for primary squamous cell carcinoma is uniformly poor irrespective of treatment, and the most suitable option may be supportive therapy. Treatment for secondary squamous cell carcinoma of the thyroid varies with the site and extent of spread of the primary tumour.
The Utility of Immunohistochemistry in Differentiating Metastatic Primary Squamous Cell Carcinoma of the Thyroid from a Primary Lung Squamous Cell Carcinoma.
Kao Nern Hoong,Tan Chien Sheng,Koh Adrian Jit Hin
Case reports in endocrinology
Primary squamous cell carcinoma of the thyroid gland (PSCCTh) and anaplastic thyroid carcinoma with extensive squamous differentiation are rare entities which pose a diagnostic challenge in determining the primary site when presented as metastases. The difficulty in confirming a thyroid primary is further compounded by the aggressive nature of these tumours which frequently present at advanced stages. We present a case in which the patient presented with a thyroid mass and a lung mass simultaneously. The risk of misinterpreting the site of primary tumour as lung is greatly increased because squamous cell carcinoma of lung is much more common than its thyroid counterpart. This case highlights the effectiveness of PAX-8 stain in determining the primary site of tumour when squamous cell carcinoma is found in both lung and thyroid gland.
Primary squamous cell carcinoma of the thyroid gland: a case report and review.
Shrestha Merica,Sridhara Shankar K,Leo Leonard J,Coppit George L,Ehrhardt Nicole M
Head & neck
BACKGROUND:Primary squamous cell carcinoma (SCC) of the thyroid gland is a rare malignancy that presents with advanced disease and poor prognosis. METHODS:A 75-year-old woman with a history of Hashimoto thyroiditis presented with 6 months of dysphagia and stridor. Imaging revealed a thyroid mass invading the larynx. Primary SCC of the thyroid was diagnosed by histopathologic and immunohistochemical evaluation. Total thyroidectomy, total laryngectomy, bilateral modified neck dissection, and adjuvant radiotherapy (RT) were performed. Radiologic follow-up at 21 months demonstrated no disease and total length of survival was 31 months. RESULTS:Despite an aggressive T4aN0M0 tumor, survival in this case was more than double the median survival rate previously reported. Concomitant Hashimoto thyroiditis is rare and histopathologic and immunohistochemical evaluation is imperative for an accurate diagnosis. CONCLUSION:The case and literature reported here support that a thorough diagnostic workup of primary SCC of the thyroid with aggressive locoregional surgery and adjuvant RT may improve the length of survival.
Primary squamous cell carcinoma of the thyroid: a case report.
Lichiardopol Corina,Şurlin Valeriu,Foarfă Maria Camelia,Ghiluşi Mirela Corina,Bondari Simona
Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie
Primary squamous cell carcinoma of the thyroid is a very rare thyroid malignancy (less than 1% of thyroid cancers) with unfavorable clinical evolution and median survival less than one year, due to highly local tumor invasiveness with airway obstruction, metastases and treatment complications. We present a 62-year-old female patient with a fixed, rapidly increasing 5 cm right thyroid nodule, generating compressive signs and significant weight loss, resembling anaplastic thyroid carcinoma. Thyroid hormones, antithyroid antibodies and calcitonin were normal. Computed tomography (CT) scan revealed mediastinal extension of the tumor and excluded the presence of lymph nodes or other tumors (T3N0M0). Total thyroidectomy was performed and histopathological evaluation revealed squamous cell carcinoma, which was confirmed by immunohistochemistry, showing diffuse positivity for CK7, CK19, CK34βE12, galectin-3, EGFR, focal positivity for p63 and negativity for TTF-1 and CD5. Subsequently, the patient underwent chemotherapy (Paclitaxel, Cisplatin, Epirubicin) and radiotherapy (40 Gy), but tumor recurrence was noticed one month after surgical resection and continued to grow despite treatment. Nodal and metastases status remained negative at regular follow-up. The patient died within one year after diagnosis. External radiotherapy and chemotherapy were not efficient in our case. New treatment options are needed to improve outcome in primary squamous cell carcinoma of the thyroid.
Primary Squamous Cell Carcinoma of the Thyroid Gland.
Ibrahim Mohd-Irman-Shah,Jusoh Yusri-Rahimi,Adam Nurul-Nadhihah,Mohamad Irfan
Iranian journal of otorhinolaryngology
INTRODUCTION:Primary squamous cell carcinoma (SCC) of the thyroid gland is one of the rarest types of all reported thyroid malignancies worldwide. It is very aggressive in nature and carries a poor prognosis. The surgical resection with adjuvant radiotherapy and chemotherapy is the most recommended treatment despite its poor reported outcome. CASE REPORT:A 74-year-old woman presented with a rapidly progressive neck swelling, with hoarseness and compressive symptoms. Physical examination revealed a multilobulated firm thyroid mass with unilateral vocal cord palsy. Histopathological findings confirmed the diagnosis of SCC while radiological investigations and panendoscopy findings ruled out the possibility of other primary tumors. A surgical intervention was performed; however, the patient eventually succumbed to death prior to undergoing an oncological treatment. CONCLUSION:With no standard consensus to guide the management plan, SCC of the thyroid gland presents a great challenge for the managing team to come up with the best treatment option, due to its unfavorable rate of survival.
Squamous cell carcinoma of thyroid: a unique type of cancer in World Health Organization Classification.
Lam Alfred King-Yin
The aim is to review the features of 117 primary squamous cell carcinomas of thyroid which meet the histological criteria of the World Health Organization classification of endocrine tumours. The carcinomas occur in 83 women and 34 men (female to male ratio is 2.4 to 1) and with median age at presentation of 64. Half of these squamous cell carcinomas of thyroid were moderately differentiated. PAX-8 protein is a sensitive marker for confirming the thyroid origin of the carcinoma. The carcinoma is also positive for p63, p40, cytokeratins 5/6, 7,19 and negative for cytokeratins 20 and 10/13. P53 overexpression is common. The most important differential diagnosis is direct infiltration or metastatic involvement by squamous cell carcinoma from other organs. Limited mutation analysis revealed BRAF mutation in some squamous cell carcinomas of the thyroid. The genetic profile appears to be different from anaplastic thyroid carcinomas. Primary squamous cell carcinoma of thyroid had lymph node involvement in 59% and distant metastases in 26%. The median survival of the patients was 8 months. Curative surgery offers the best survival for the patients with the carcinoma. To conclude, primary squamous cell carcinoma of the thyroid gland has distinctive clinical, pathological and molecular profiles. It is important to recognize this unique variant of thyroid carcinoma for possible curative surgical resection and to do more genomic works on the entity to uncover the molecular pathogenesis.
Primary Squamous Cell Carcinoma in the Thyroid Gland: A Population-Based Analysis Using the SEER Database.
Yang Shuwen,Li Cunfu,Shi Xiao,Ma Ben,Xu Weibo,Jiang Hongyi,Liu Wanlin,Ji Qinghai,Wang Yu
World journal of surgery
OBJECTS:To evaluate prognostic factors and treatment outcomes of primary squamous cell carcinoma in thyroid (PSCCTh) over the past decades using a large national database. METHODS:All patients diagnosed with PSCCTh between 1973 and 2015 were identified with the Surveillance, Epidemiology, and End Results Program (SEER) 18-registry database. Relevant clinical data were collected, and prognostic factors of overall survival (OS) and disease-specific survival (DSS) were analyzed. RESULTS:This cohort study included 242 patients, accounting for 0.12% of all primary thyroid carcinomas from 1973 to 2015 nationwide. Of the patients with PSCCTh, 75% were older than 60 years at diagnosis. Patient age older than 60 years (HR 2.242, 95% CI 1.367-3.676, P = 0.001) and a tumor size larger than or equal to 50 mm (HR 1.479, 95% CI 1.011-2.165, P = 0.044) were independent negative prognostic factors. The univariate analysis suggested that the morphological subtype (OS, P = 0.033; DSS, P = 0.048), clinical treatment modality (OS, P < 0.0001; DSS, P < 0.0001), and T stage (OS, P = 0.004; DSS, P = 0.001) were important predictive factors for OS and DSS. In contrast, gender, race, year of diagnosis, geographic location, N stage, and M stage were not prognostic factors. CONCLUSIONS:PSCCTh is a rare malignancy with an aggressive nature and poor prognosis. Survival is predicted by the treatment modality, patient age, T stage, tumor size, and morphological subtypes. This study showed that early diagnosis and complete surgical resection plus adjuvant radiation therapy were associated with a better outcome.
De-differentiation of papillary thyroid carcinoma into squamous cell carcinoma in an elderly patient: A case report.
RATIONALE:The unpredictability of thyroid cancer can be striking, as the disease may rapidly progress to death in some individuals. Herein, we reported a rare case of aggressive papillary thyroid cell carcinoma (PTC) in an elderly patient de-differentiated into squamous cell carcinoma (SCC). PATIENT CONCERNS:We describe a case of a 79-year-old Thai woman presented with hoarseness and neck mass for 2 months and she had been diagnosed with a 3-cm papillary thyroid carcinoma (PTC) in the right side of the thyroid gland. Later on PTC de-differentiated into SCC within 3 years after initial presentation. DIAGNOSIS:De-differentiation from papillary thyroid carcinoma to squamous cell carcinoma. INTERVENTIONS:The patient underwent a total thyroidectomy at the initial hospital and received high dose radioactive iodine (RAI) treatment at our hospital 1 month following the surgery and then was lost to follow-up. Two years later she came back with new development of right solid-cystic neck mass which was found to be recurrent PTC. A radical neck dissection was done and another high dose RAI treatment was given. However, she developed recurrent mass with tenderness at the site above previous solid cystic mass 6 months later. Re-exploration of the neck mass revealed an inflamed midline mass 2 cm with enlarged right lateral cervical lymph nodes. OUTCOMES:A histopathological examination of the midline neck mass showed poorly differentiated SCC with lymphatic invasion. The intermingling of two morphologically distinct tumors, a typical PTC and a poorly differentiated SCC, had been identified in 1 out of 14 excised cervical lymph nodes. The patient underwent external beam radiation without chemotherapy. She is still in stable condition at 18 months post-treatment. LESSONS:This case clearly demonstrated that SCC transformed from a pre-existing PTC. The clinician should consider a possible transformation of papillary thyroid cancer into more aggressive histological types in elderly patients who present with rapidly progressive clinical behavior. However, some patients could have long-term survival if the tumor did not transform into anaplastic thyroid cancer.
Squamous cell carcinoma of the thyroid gland in an elderly female presenting as a rapidly enlarging thyroid mass.
Othman Ramadhan T,Baizeed Azad Mustafa Ahmed,Mohammed Ayad Ahmad
International journal of surgery case reports
BACKGROUND:Squamous cell carcinoma of the thyroid gland is an extremely rare tumor with a very aggressive clinical behavior and poor prognosis. The tumor may arise as a primary tumor within the thyroid gland or as a component of anaplastic or undifferentiated thyroid tumors. CASE PRESENTATION:A 70-year-old lady with history of long standing multinodular goiter presented with progressive enlargement of a midline nodule for 3 months which was associated with dyspnea and dry cough. The mass was hard and fixed. The voice was normal, other parts of the general examination were unremarkable. Fine needle aspiration was done for the mass which revealed malignant cells mixed with inflammatory cells. During surgery there was a hard and fixed mass arising from the isthmus of the thyroid gland that was locally invading, complete excision was not possible, debulking was done. Histopathology showed moderately differentiated squamous cell carcinoma of the thyroid gland. The tumor underwent local progression 6 months later and the patient was sent for radiotherapy. CONCLUSION:When thyroid tumor is advanced at time of diagnosis, radiotherapy is the main form of treatment which may induce reduction in the size of the tumor and decrease pain, radiotherapy may also be given on neoadjuvant bases which may render resection possible in some patients. The tumor is usually not responsive to chemotherapy. The overall survival is uniformly poor regardless of the primary form of treatment, the median survival of the patients from the time of diagnosis is few months in most cases.