Eugene Hung Chih Wong1, Nora Tetter1, Alexandar Tzankov2, Laurent Muller1. 1. Department of Otolaryngology, Head and Neck Surgery, University Hospital of Basel, Basel, Switzerland. 2. Institute of Medical Genetics and Pathology, University Basel, Basel, Switzerland.
Abstract
BACKGROUND: Carcinoma showing thymus-like elements (CASTLE) is a rare tumor that normally affects the thyroid gland and was thought to arise from either the remnants of the branchial pouch or the ectopic cervical thymic tissue. These tumors show strong immunopositivity for CD5, P63, and CD117. Most CASTLE of the thyroid gland is treated with surgery with or without adjuvant radiotherapy or chemotherapy. METHOD: A 55-year-old woman presented with a slow-growing right parotid mass. A right total parotidectomy and ipsilateral selective neck dissection were performed and the diagnosis of CASTLE was made after confirmation with an immunohistochemistry test. She received radiotherapy postoperatively. RESULTS: Genetic sequencing showed alterations in the PPARG, BRCA2, and NOTCH1 genes. She remained disease free for >1 year after treatment. CONCLUSION: We believe that this is the first reported case of CASTLE in the parotid gland. Clinicians should be aware of this rare entity and consider this differential diagnosis after ruling out other common parotid lesions.
BACKGROUND:Carcinoma showing thymus-like elements (CASTLE) is a rare tumor that normally affects the thyroid gland and was thought to arise from either the remnants of the branchial pouch or the ectopic cervical thymic tissue. These tumors show strong immunopositivity for CD5, P63, and CD117. Most CASTLE of the thyroid gland is treated with surgery with or without adjuvant radiotherapy or chemotherapy. METHOD: A 55-year-old woman presented with a slow-growing right parotid mass. A right total parotidectomy and ipsilateral selective neck dissection were performed and the diagnosis of CASTLE was made after confirmation with an immunohistochemistry test. She received radiotherapy postoperatively. RESULTS: Genetic sequencing showed alterations in the PPARG, BRCA2, and NOTCH1 genes. She remained disease free for >1 year after treatment. CONCLUSION: We believe that this is the first reported case of CASTLE in the parotid gland. Clinicians should be aware of this rare entity and consider this differential diagnosis after ruling out other common parotid lesions.
Authors: A Marx; T Rüdiger; E Rößner; A Tzankov; V T de Montpréville; R R Rieker; P Ströbel; C-A Weis Journal: Pathologe Date: 2018-09 Impact factor: 1.011