Tapescu Iulia, Kohler Abigail, Sangal Neel R, Brant Jason A, Brody Robert M, Chao Timothy, Carey Ryan M
Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Department of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Head Neck. 2025 Mar;47(3):899-905. doi: 10.1002/hed.27969. Epub 2024 Nov 4.
Spindle epithelial tumors with thymus-like differentiation (SETTLE) and carcinomas showing thymus-like differentiation (CASTLE) are rare intrathyroid tumors.
This retrospective cohort study included patients diagnosed with SETTLE, CASTLE, and papillary thyroid carcinoma (PTC) from 2004 to 2020 within the National Cancer Database (NCDB). Demographic, tumor, and treatment characteristics were compared. Overall survival (OS) was analyzed using the Kaplan-Meier method and Cox regression models.
This study identified 19 patients with CASTLE, 11 with SETTLE, and 483 474 with PTC. CASTLE and SETTLE patients had larger tumors, lymphovascular invasion, and positive surgical margins. They were rarely treated with radioactive iodine treatment but frequently received external beam radiation and chemotherapy. Five-year OS was significantly lower for CASTLE and SETTLE compared to PTC. SETTLE was associated with an increased risk of death.
SETTLE and CASTLE are rare intrathyroid tumors with worse survival compared to PTC, often managed with radiation, chemotherapy, and surgery.
具有胸腺样分化的梭形上皮肿瘤（SETTLE）和显示胸腺样分化的癌（CASTLE）是罕见的甲状腺内肿瘤。
这项回顾性队列研究纳入了2004年至2020年期间在国家癌症数据库（NCDB）中被诊断为SETTLE、CASTLE和甲状腺乳头状癌（PTC）的患者。比较了人口统计学、肿瘤和治疗特征。使用Kaplan-Meier方法和Cox回归模型分析总生存期（OS）。
本研究确定了19例CASTLE患者、11例SETTLE患者和483474例PTC患者。CASTLE和SETTLE患者的肿瘤更大，有淋巴管侵犯和手术切缘阳性。他们很少接受放射性碘治疗，但经常接受外照射放疗和化疗。与PTC相比，CASTLE和SETTLE的5年总生存期显著更低。SETTLE与死亡风险增加相关。
SETTLE和CASTLE是罕见的甲状腺内肿瘤，与PTC相比生存期更差，通常采用放疗、化疗和手术进行治疗。
