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组织学上模拟鳞状细胞癌的转移性乳头状甲状腺癌病变的间变性转化:一例报告。

Anaplastic transformation of metastatic papillary thyroid carcinoma lesion histologically mimicking a squamous cell carcinoma: A case report.

作者信息

Yulian Erwin Danil, Martiana Ryna Zahrotul, Wahyono Yuddi, Ham Maria Francisca, Aqil Faisal Mohammad Rifqi

机构信息

Division of Oncology Surgery, Department of Surgery, Faculty of Medicine, Universitas Indonesia - Cipto Mangunkusumo Hospital / Pertamina Central Hospital, Jakarta, Indonesia.

Laboratory Anatomical Pathology, Pertamina Central Hospital, Jakarta, Indonesia.

出版信息

Int J Surg Case Rep. 2024 Nov;124:110396. doi: 10.1016/j.ijscr.2024.110396. Epub 2024 Sep 30.

Abstract

INTRODUCTION

The incidence of anaplastic transformation of thyroid cancer from Papillary Thyroid Carcinoma (PTC) is a rare tumor event, which ranges from 1 to 2 % of all cases of thyroid malignancy. Anaplastic transformation is often reported in primary lesions, but is rarely found in metastatic lesions from Differentiated Thyroid Carcinoma (DTC).

PRESENTATION OF CASE

This case report reports a unique tumor process where a 70-year-old woman had a metastatic lesion in the Mandible from PTC which transformed into ATC with histological features resembling squamous cell carcinoma-type. Immunohistochemical examination was able to prove that the lesion in the Mandible is a type of undifferentiated Thyroid carcinoma (anaplastic) with a squamous pattern originating from PTC.

DISCUSSION

This type of tumor with histological variant images that resemble other types of tumors is a challenge for diagnosis and appropriate management, so understanding the variants of this type of ATC is important for better management.

CONCLUSION

Although rare, anaplastic transformation can occur in metastatic sites of PTC. This necessitates the need for early accurate diagnosis through IHC assessment and somatic mutation testing so that appropriate treatment can be delivered.

摘要

引言

甲状腺癌由乳头状甲状腺癌(PTC)发生间变性转化是一种罕见的肿瘤事件,在所有甲状腺恶性肿瘤病例中占1%至2%。间变性转化常报道于原发性病变,但在分化型甲状腺癌(DTC)的转移病灶中很少见。

病例介绍

本病例报告了一个独特的肿瘤过程,一名70岁女性的下颌骨出现PTC转移病灶,该病灶转化为具有类似鳞状细胞癌组织学特征的ATC。免疫组织化学检查能够证实下颌骨的病灶是一种起源于PTC的具有鳞状模式的未分化甲状腺癌(间变性)。

讨论

这种具有类似于其他类型肿瘤组织学变异图像的肿瘤类型对诊断和适当管理构成挑战,因此了解这种类型的ATC变异对于更好的管理很重要。

结论

尽管罕见,但间变性转化可发生在PTC的转移部位。这就需要通过免疫组化评估和体细胞突变检测进行早期准确诊断,以便能够提供适当的治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bbdc/11497369/9914024593a3/ga1.jpg

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