Halicek Martin T, Scott Caleb, Zimmermann Terence, Watson Brian
Emory University Hospital, Atlanta, GA.
Grand Strand Medical Center, Myrtle Beach SC.
HCA Healthc J Med. 2024 Mar 29;5(1):39-43. doi: 10.36518/2689-0216.1570. eCollection 2024.
Primary mucinous carcinoma of the thyroid is an exceedingly rare malignancy that is histologically similar to mucinous carcinoma of other sites. Accurate diagnosis is a challenging yet crucial component of clinical management for both patients and our understanding of this rare disease.
We report the case of a 69-year-old male patient with primary mucinous carcinoma of the thyroid. Microscopic examination of a biopsy specimen showed fibrous tissue, which was extensively and irregularly infiltrated by a cytologically malignant epithelial neoplasm showing glandular differentiation with mucin production. Immunohistochemistry demonstrated that tumor cells were positive for TTF1, thyroglobulin, CK7, and PAX8. Co-expression of TTF1 and PAX8 is most commonly seen in thyroid tumors. These findings support our diagnosis of mucinous carcinoma of thyroid origin, which is rare and highly aggressive.
In this report, we present the only documented case of primary mucinous carcinoma of the thyroid reported in the United States in the last decade. The diagnosis of primary mucinous carcinoma of the thyroid can be challenging. Therefore, we discuss and detail the clinicopathologic tumor profile and provide more current, detailed histological criteria to assist in the diagnosis of this rare disease.
甲状腺原发性黏液癌是一种极为罕见的恶性肿瘤，在组织学上与其他部位的黏液癌相似。准确诊断对于患者的临床管理以及我们对这种罕见疾病的理解而言，是一项具有挑战性但又至关重要的工作。
我们报告一例69岁男性甲状腺原发性黏液癌患者。对活检标本进行显微镜检查显示为纤维组织，其被一种细胞学上呈恶性的上皮性肿瘤广泛且不规则地浸润，该肿瘤显示出腺管分化并产生黏液。免疫组化显示肿瘤细胞TTF1、甲状腺球蛋白、CK7和PAX8呈阳性。TTF1和PAX8的共表达在甲状腺肿瘤中最为常见。这些发现支持我们对甲状腺源性黏液癌的诊断，这种癌症罕见且具有高度侵袭性。
在本报告中，我们呈现了过去十年间美国唯一一例有记录的甲状腺原发性黏液癌病例。甲状腺原发性黏液癌的诊断可能具有挑战性。因此，我们讨论并详细阐述了临床病理肿瘤特征，并提供了更新、更详细的组织学标准以协助诊断这种罕见疾病。
