F Dirilenoglu1, A Kahraman Akkalp2, H Bag3, T Atasever Rezanko2, Z Kucukodaci2. 1. Near East University, Faculty of Medicine, Dept. of Pathology, Nicosia, Cyprus, Izmir, Turkey. 2. Izmir Katip Celebi University Ataturk Training and Research Hospital, Dept. of Pathology, Izmir, Turkey. 3. Dept. of General Surgery, Izmir, Turkey.
Abstract
CONTEXT: Noninvasive encapsulated anaplastic thyroid carcinomas (NE-ATCs) have been described in few case reports, and consistently associated with favorable outcome compared to the classical ATCs. OBJECTIVE: Our aim is to remark a rare histological finding in ATCs, encapsulation, which has been associated with a favorable outcome. DESIGN: We have documented a rare case of an NE-ATC with its clinical, pathological, and molecular features. We also provided a thorough discussion of all the encapsulated ATCs reported in the literature. SUBJECTS AND METHODS: A 50-year-old woman with an unremarkable medical history, who presented with a thyroid nodule, and diagnosed as "follicular lesion of undetermined significance" by fine needle aspiration biopsy. The patient was lost to follow-up for six years and revisited upon her neck disturbances and underwent total thyroidectomy. RESULTS: Sections of the right lobe revealed a grossly encapsulated nodular lesion, measuring 75x55x55 mm. Histologically, the tumor consisted of both carcinomatous and sarcomatous components supported by immunohistochemical stains. Necrosis and atypical mitotic figures were evident. Capsular and/or vascular invasion was not identified. There were no BRAF codon 600, KRAS, NRAS mutations and RET/PTC rearrangement. During three-month follow-up, the patient was free of disease without adjuvant therapy. CONCLUSION: Encapsulated ATCs tend to follow a favorable clinical course and may deserve conservative treatment approaches.
CONTEXT: Noninvasive encapsulated anaplastic thyroid carcinomas (NE-ATCs) have been described in few case reports, and consistently associated with favorable outcome compared to the classical ATCs. OBJECTIVE: Our aim is to remark a rare histological finding in ATCs, encapsulation, which has been associated with a favorable outcome. DESIGN: We have documented a rare case of an NE-ATC with its clinical, pathological, and molecular features. We also provided a thorough discussion of all the encapsulated ATCs reported in the literature. SUBJECTS AND METHODS: A 50-year-old woman with an unremarkable medical history, who presented with a thyroid nodule, and diagnosed as "follicular lesion of undetermined significance" by fine needle aspiration biopsy. The patient was lost to follow-up for six years and revisited upon her neck disturbances and underwent total thyroidectomy. RESULTS: Sections of the right lobe revealed a grossly encapsulated nodular lesion, measuring 75x55x55 mm. Histologically, the tumor consisted of both carcinomatous and sarcomatous components supported by immunohistochemical stains. Necrosis and atypical mitotic figures were evident. Capsular and/or vascular invasion was not identified. There were no BRAF codon 600, KRAS, NRAS mutations and RET/PTC rearrangement. During three-month follow-up, the patient was free of disease without adjuvant therapy. CONCLUSION: Encapsulated ATCs tend to follow a favorable clinical course and may deserve conservative treatment approaches.
Entities:
Keywords:
anaplastic carcinoma; capsule; carcinosarcoma; good prognosis; noninvasive; thyroid
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