Kawano Fumiaki, Chiyotanda Teru, Nakame Kazuhiko, Meiri Satoru, Fukushima Tsuyoshi, Shirahama Kousei, Sato Yuichiro, Yamaguchi Hideki, Ikenoue Makoto, Munakata Shun, Higuchi Kazuhiro, Takeno Shinsuke, Nanashima Atsushi
Endocrinol Diabetes Metab Case Rep. 2025 May 14;2025(2). doi: 10.1530/EDM-25-0014. Print 2025 Apr 1.
Spindle epithelial tumor with thymic-like elements (SETTLE) is an extremely rare tumor that occurs primarily in the thyroid gland. Histologically, SETTLE is characterized by the presence of spindle-shaped epithelial cells and glandular structures. However, it is known that diagnosis via fine-needle aspiration cytology can be challenging. SETTLE predominantly occurs in younger individuals and has a less favorable prognosis compared to differentiated thyroid carcinoma. Therefore, ensuring accurate diagnosis and appropriate treatment is crucial. We encountered a case of spindle epithelial tumor with thymus-like differentiation in a 10-year-old patient for whom the preoperative diagnosis was successfully established through fine-needle aspiration cytology, which facilitated appropriate surgical resection. Comprehensive histopathological examination and immunohistochemical analysis are essential to ensure appropriate management and surveillance of SETTLE.
A rare thyroid tumor, spindle epithelial tumor with thymic-like elements (SETTLE), was diagnosed preoperatively and treated surgically. SETTLE presents with characteristic histological features that must be recognized for accurate diagnosis. In addition, diagnosis through cytology is often challenging. The primary treatment for SETTLE is surgical intervention as radiotherapy and pharmacological treatments are generally not expected to be highly effective. Radical resection is the only effective treatment, making the selection of the surgical procedure according to the stage of the disease essential.
伴有胸腺样成分的梭形上皮肿瘤（SETTLE）是一种极为罕见的肿瘤，主要发生于甲状腺。在组织学上，SETTLE的特征为存在梭形上皮细胞和腺管结构。然而，已知通过细针穿刺细胞学进行诊断具有挑战性。SETTLE主要发生于较年轻个体，与分化型甲状腺癌相比，其预后较差。因此，确保准确诊断和恰当治疗至关重要。我们遇到一例10岁患者患有伴有胸腺样分化的梭形上皮肿瘤，通过细针穿刺细胞学成功进行了术前诊断，这有助于进行恰当的手术切除。全面的组织病理学检查和免疫组化分析对于确保SETTLE的恰当管理和监测至关重要。
一种罕见的甲状腺肿瘤，伴有胸腺样成分的梭形上皮肿瘤（SETTLE），术前得到诊断并接受了手术治疗。SETTLE具有特征性的组织学特征，为准确诊断必须予以识别。此外，通过细胞学进行诊断往往具有挑战性。SETTLE的主要治疗方法是手术干预，因为放疗和药物治疗通常预计效果不佳。根治性切除是唯一有效的治疗方法，因此根据疾病分期选择手术方式至关重要。
