Abdellaoui Wahiba, Assarrar Imane, Benyakhlef Salma, Tahri Abir, Messaoudi Najoua, Haloui Anass, Rouf Siham, Bennani Amal, Latrech Hanane
Department of Endocrinology-Diabetology-Nutrition, Mohammed VI University Hospital, Medical School, Mohammed the First University, Oujda, Morocco.
Anathomopathology Laboratory, Mohammed VI University Hospital, Medical School, Mohammed the First University, Oujda, Morocco.
Ann Med Surg (Lond). 2022 Apr 6;77:103592. doi: 10.1016/j.amsu.2022.103592. eCollection 2022 May.
Insular thyroid carcinoma (ITC) was defined as a rare malignant thyroid cancer standing in an intermediate position between the well-differentiated (papillary and follicular) and the anaplastic thyroid carcinomas. The incidence was estimated around <1% and 10% worldwide. Despite its rarity, it remains the main cause of death from non-anaplastic follicular cell-derived thyroid cancers.
A 27-year-old single male admitted for a history of a thyroid nodule and intrathoracic extension; with local mass effect, deviating the brachiocephalic trunk to the right. He underwent a total thyroidectomy. Histopathological examination showed a poorly differentiated insular thyroid carcinoma. Radioactive iodine-131 therapy was administred at a dose of 100 mCi, and the patient was maintained on TSH-suppressive therapy. Ultrasensitive Thyroglobulin measurement after thyroxine withdrawal, taken 2 years after radioactive iodine treatment was undetectable as well as thyroid antithyroglobulin antibodies.
Our clinical case would enrich the global registry of insular thyroid carcinomas' cases. The main challenge is early detection, aggressive intervention, and close follow-up of affected patients. The advancement in ultra-deep sequencing technologies, will contribute in the development of novel targeted therapies aiming to reduce morbidity and mortality and improve the outcomes in PDTC patients as well.
甲状腺岛状癌（ITC）被定义为一种罕见的恶性甲状腺癌，处于高分化（乳头状和滤泡状）甲状腺癌与未分化甲状腺癌之间的中间位置。据估计，其全球发病率在1%至10%之间。尽管它很罕见，但仍然是源自滤泡细胞的非未分化甲状腺癌的主要死亡原因。
一名27岁单身男性因甲状腺结节病史及胸内扩展入院；伴有局部肿块效应，将头臂干向右推移。他接受了全甲状腺切除术。组织病理学检查显示为低分化甲状腺岛状癌。给予100毫居里的放射性碘-131治疗，患者接受促甲状腺激素抑制治疗。放射性碘治疗2年后，在停用甲状腺素后进行的超敏甲状腺球蛋白测量以及甲状腺抗甲状腺球蛋白抗体检测均未发现异常。
我们的临床病例将丰富全球甲状腺岛状癌病例登记库。主要挑战在于对受影响患者进行早期检测、积极干预和密切随访。超深度测序技术的进步将有助于开发新的靶向治疗方法，旨在降低发病率和死亡率，并改善甲状腺高分化癌患者的治疗效果。
