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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). PATIEN...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7440287/ https://www.ncbi.nlm.nih.gov/pubmed/32312017 http://dx.doi.org/10.1097/MD.0000000000019892 |
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author | Thewjitcharoen, Yotsapon Krittiyawong, Sirinate Butadej, Siriwan Nakasatien, Soontaree Polchart, Somsong Junyangdikul, Pairoj Kanchanapituk, Auchai Himathongkam, Thep |
author_facet | Thewjitcharoen, Yotsapon Krittiyawong, Sirinate Butadej, Siriwan Nakasatien, Soontaree Polchart, Somsong Junyangdikul, Pairoj Kanchanapituk, Auchai Himathongkam, Thep |
author_sort | Thewjitcharoen, Yotsapon |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-7440287 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-74402872020-09-04 De-differentiation of papillary thyroid carcinoma into squamous cell carcinoma in an elderly patient: A case report Thewjitcharoen, Yotsapon Krittiyawong, Sirinate Butadej, Siriwan Nakasatien, Soontaree Polchart, Somsong Junyangdikul, Pairoj Kanchanapituk, Auchai Himathongkam, Thep Medicine (Baltimore) 4300 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. Wolters Kluwer Health 2020-04-17 /pmc/articles/PMC7440287/ /pubmed/32312017 http://dx.doi.org/10.1097/MD.0000000000019892 Text en Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0 |
spellingShingle | 4300 Thewjitcharoen, Yotsapon Krittiyawong, Sirinate Butadej, Siriwan Nakasatien, Soontaree Polchart, Somsong Junyangdikul, Pairoj Kanchanapituk, Auchai Himathongkam, Thep De-differentiation of papillary thyroid carcinoma into squamous cell carcinoma in an elderly patient: A case report |
title | De-differentiation of papillary thyroid carcinoma into squamous cell carcinoma in an elderly patient: A case report |
title_full | De-differentiation of papillary thyroid carcinoma into squamous cell carcinoma in an elderly patient: A case report |
title_fullStr | De-differentiation of papillary thyroid carcinoma into squamous cell carcinoma in an elderly patient: A case report |
title_full_unstemmed | De-differentiation of papillary thyroid carcinoma into squamous cell carcinoma in an elderly patient: A case report |
title_short | De-differentiation of papillary thyroid carcinoma into squamous cell carcinoma in an elderly patient: A case report |
title_sort | de-differentiation of papillary thyroid carcinoma into squamous cell carcinoma in an elderly patient: a case report |
topic | 4300 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7440287/ https://www.ncbi.nlm.nih.gov/pubmed/32312017 http://dx.doi.org/10.1097/MD.0000000000019892 |
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