Department of Pathology, Zhuji People's Hospital of Zhejiang Province, Jianming Road, Taozhu Street, Zhuji, Zhejiang, China.
Department of Pathology, Zhejiang Hospital, 1229 Gudun Road, Xihu District, Hangzhou, Zhejiang, China.
J Med Case Rep. 2024 Mar 22;18(1):123. doi: 10.1186/s13256-024-04450-1.
Giant cell tumor of soft tissue is a low malignant uncommon neoplasm, with histologic features and immunophenotype similar to its bone counterpart. Primary giant cell tumor of soft tissue in the thyroid gland is considered an exceedingly rare entity.
We describe a case of primary thyroid giant cell tumor of soft tissue in a 69-year-old Chinese female patient. Neck ultrasonography showed a 19 mm × 12 mm × 5 mm nodule with heterogeneous echo and clear boundary located within the left thyroid. Histopathological examination revealed that the neoplasm was composed of two morphological components, mononuclear cells admixed with multinucleated osteoclast-like giant cells. Immunohistochemically, the tumor cells were positive for CD68 and vimentin, but were negative for epithelial membrane antigen, cytokeratin, and additional muscle markers. She underwent left unilateral thyroidectomy, and total thyroidectomy was performed for local recurrence 3 months later. The patient remained well without recurrence or metastasis following up for 12 months.
The significance of this case lies in its rarity, the challenge of preoperative clinical diagnosis, and the differential diagnosis with other malignancies.
软组织巨细胞瘤是一种低度恶性的罕见肿瘤，其组织学特征和免疫表型与骨巨细胞瘤相似。甲状腺原发性软组织巨细胞瘤被认为是一种极其罕见的实体瘤。
我们描述了一例 69 岁中国女性患者的甲状腺原发性软组织巨细胞瘤。颈部超声显示左甲状腺内有一个 19mm×12mm×5mm 的结节，回声不均匀，边界清晰。组织病理学检查显示，该肿瘤由两种形态成分组成，单核细胞混合多核破骨样巨细胞。免疫组化显示，肿瘤细胞阳性表达 CD68 和波形蛋白，而阴性表达上皮膜抗原、细胞角蛋白和其他肌肉标志物。患者接受了左侧甲状腺腺叶切除术，3 个月后因局部复发行甲状腺全切除术。患者在随访 12 个月时无复发或转移，情况良好。
本病例的意义在于其罕见性、术前临床诊断的挑战性以及与其他恶性肿瘤的鉴别诊断。
