Subramanian Nitya, Agarwal Sangeet Kumar, Agarwal Alok, Gupta Pallav
Department of ENT, Sir Ganga Ram Hospital, New Delhi-110060.
Department of Pathology, Sir Ganga Ram Hospital, New Delhi-110060.
Iran J Otorhinolaryngol. 2022 Jan;34(120):55-57. doi: 10.22038/IJORL.2021.48526.2614.
Thyroid cancers constitute 0.5%- 1% of all cancers of which differentiated cancers are most common. Mixed thyroid carcinomas are rare entities comprising only 0.5% of thyroid cancers. These tumours pose challenges in diagnosis by fine needle aspiration cytology.
Here, we present two rare cases of these mixed thyroid carcinomas. The first is that of a 21 year old female diagnosed with medullary thyroid carcinoma by the method of fine needle aspiration cytology (FNAC). She underwent definitive surgical treatment. Final histopathology revealed diagnosis of a nodular tumour with mixed features predominantly medullary carcinoma with areas of follicular carcinoma, confirmed on immunohistochemistry. Second report is that of a 45-year- old female diagnosed as medullary thyroid carcinoma on fine needle aspiration cytology (FNAC). Definitive surgical treatment was performed. Histopathology showed a mixed tumour with medullary and papillary components as confirmed through the process of immunohistochemistry.
The knowledge of these rare carcinomas is important in avoiding a dilemma in management of this condition. Detection of these mixed tumours is difficult by FNAC. The definitive treatment essentially requires recognition of medullary component. We re-emphasize the importance of immune-histochemistry in arriving at an accurate diagnosis.
甲状腺癌占所有癌症的0.5%-1%,其中分化型癌症最为常见。混合性甲状腺癌是罕见的实体,仅占甲状腺癌的0.5%。这些肿瘤在细针穿刺细胞学诊断中具有挑战性。
在此,我们呈现两例罕见的混合性甲状腺癌病例。第一例是一名21岁女性,通过细针穿刺细胞学检查(FNAC)诊断为甲状腺髓样癌。她接受了确定性手术治疗。最终组织病理学显示为一个具有混合特征的结节性肿瘤,主要为髓样癌,伴有滤泡癌区域,免疫组化证实。第二例报告是一名45岁女性,细针穿刺细胞学检查(FNAC)诊断为甲状腺髓样癌。进行了确定性手术治疗。组织病理学显示为一个具有髓样和乳头状成分的混合性肿瘤,免疫组化过程证实。
了解这些罕见的癌症对于避免这种疾病管理中的困境很重要。通过FNAC检测这些混合性肿瘤很困难。确定性治疗基本上需要识别髓样成分。我们再次强调免疫组化在做出准确诊断中的重要性。