Matsuo Mioko, Tuneyoshi Masazumi, Mine Mari
Department of Head and Neck Surgery, Japan Community Health Care Organization Kyushu Hospital, 1-8-1 Kishinoura, Yahatanishi-ku, Kitakyushu-City, Fukuoka, 806-8501, Japan.
Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Diagn Pathol. 2016 Jun 10;11(1):48. doi: 10.1186/s13000-016-0500-8.
Primary mucinous carcinoma of the thyroid gland is a rare disease; only 6 cases of primary mucinous carcinoma of the thyroid have been previously reported. Primary mucinous carcinoma of the thyroid gland with incomplete tumor resection tends to be associated with a poor prognosis, resulting in death within a few months. An early and appropriate diagnosis may contribute to improvement in patient prognosis; however, it is extremely difficult to diagnose primary mucinous carcinoma of the thyroid. We present the seventh reported case of primary mucinous carcinoma in the thyroid gland; moreover, rhabdoid cells were detected, which, to our knowledge, is a novel finding.
An 81-year-old Japanese woman was initially diagnosed with a poorly differentiated thyroid carcinoma, and she underwent a hemithyroidectomy. Pathological examination revealed the presence of abundant mucus and agglomeration of large atypical cells. Rhabdoid cells were also seen scattered among the tumor cells. Immunostaining was performed for various markers, and on the basis of these results, we diagnosed the lesion as primary mucinous carcinoma with rhabdoid cells in the thyroid gland. Ten months after surgery, recurrence was noted in the paratracheal lymph nodes; therefore, total resection of the residual thyroid gland and paratracheal lymphadenectomy with thyroid-stimulating hormone suppression were performed. The patient is currently alive and disease-free.
The current case is of interest not only because of the rare histological findings, but also because the patient achieved long-term survival following diagnosis of a mucinous carcinoma. We believe this report will be helpful for diagnosing future cases of mucinous carcinoma of the thyroid.
甲状腺原发性黏液癌是一种罕见疾病；此前仅报道过6例甲状腺原发性黏液癌。甲状腺原发性黏液癌若肿瘤切除不完全，往往预后较差，患者会在数月内死亡。早期且恰当的诊断可能有助于改善患者预后；然而，甲状腺原发性黏液癌极难诊断。我们报告了第7例甲状腺原发性黏液癌病例；此外，还检测到了横纹肌样细胞，据我们所知，这是一项新发现。
一名81岁的日本女性最初被诊断为低分化甲状腺癌，随后接受了甲状腺半切术。病理检查显示存在大量黏液以及大的非典型细胞聚集。在肿瘤细胞中还散在可见横纹肌样细胞。对多种标志物进行了免疫染色，基于这些结果，我们将该病变诊断为甲状腺原发性黏液癌伴横纹肌样细胞。术后10个月，气管旁淋巴结出现复发；因此，进行了残余甲状腺全切除术及气管旁淋巴结清扫术，并给予促甲状腺激素抑制治疗。患者目前存活且无疾病。
本病例不仅因其罕见的组织学表现而引人关注，还因为患者在黏液癌诊断后实现了长期生存。我们相信本报告将有助于未来甲状腺黏液癌病例的诊断。
