Cohexisting Medullary and Papillary Thyroid Cancer

Gianlorenzo Dionigi; Maria Laura Tanda; Eliana Piantanida; Silvia Uccella; Stefano La Rosa; Davide Inversini; Matteo Lavazza; Vincenzo Pappalardo; Fausto Sessa; Liu Xiaoli

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자료유형: 학술저널

저자정보: Gianlorenzo Dionigi Maria Laura Tanda Eliana Piantanida Silvia Uccella Stefano La Rosa Davide Inversini Matteo Lavazza Vincenzo Pappalardo Fausto Sessa Liu Xiaoli

저널정보: 대한갑상선-내분비외과학회 The Journal of Endocrine Surgery The Journal of Endocrine Surgery 제17권 제2호

발행연도: 2017.1

수록면: 57 - 62 (6page)

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Purpose: Papillary thyroid carcinomas (PTCs) and medullary thyroid carcinomas (MTCs) have always been considered different in terms of their incidence rates, cell origins, and histopathological features. Simultaneous occurrence of both disease entities is very rare. Methods: We describe a series of cases with simultaneous MTC and PTC occurrences in the thyroid gland. Results: From 2,897 patients (mean age, 49.2±12.5; 81% women) who underwent thyroidectomy for cancer between 2000 and 2015, we reviewed 11 cases of simultaneous occurrence of MTCs and PTCs. Multifocal PTC with simultaneous MTC was detected in 5 of the 11 cases (45%). Of these PTC patients, 2 had 2 foci, 2 had 3 foci, and 1 had 4 foci. There was 1 case of multifocal MTC with solitary PTC. One patient presented with “composite thyroid carcinoma” with mixed features of MTCs and PTCs. Eight patients (72%) presented an association with diffuse lymphocytic thyroiditis. The sizes of the tumors were 1.95±0.23 cm vs. 1.20±0.20 cm for PTCs and MTCs, respectively (P=0.531). The prevalence of extrathyroidal extension was 33.1% vs. 30.2% for PTCs and MTCs, respectively (P=0.282). All patients underwent total thyroidectomy and central neck node dissection. Radio iodine was delivered to 44% of patients. Follow-up review revealed 9 disease-free patients and 1 with local neck recurrence, while 1 patient died due to non-thyroid reasons. Conclusion: There are only 30 reports describing a total of 50 cases in the English literature regarding concurrent PTC and MTC in the same gland. This study represents one of the largest case series. Whether the incidence of another cancer in these patients is coincidental, or due to the possible activation of a common tumorigenic pathway for both follicular and parafollicular thyroid cells, remains to be elucidated.

#Carcinoma #papillary #Carcinoma #medullary #Thyroid neoplasms #Synchronous neoplasms #Complications #Therapy

참고문헌 (10)

참고문헌 신청

Apel RL / 1994 / A metastasizing composite carcinoma of the thyroid with distinct medullary and papillary components / Arch Pathol Lab Med 118 : 1143 ~ 1147

Bounacer A / 1997 / High prevalence of activating RET proto-oncogene rearrangements, in thyroid tumors from patients who had received external radiation / Oncogene 15 : 1263

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Ljungberg O / 1983 / A compound follicular-parafollicular cell carcinoma of the thyroid: a new tumor entity? / Cancer 52 : 1053 ~ 1061

Maia AL / 2017 / Advances and controversies in the management of medullary thyroid carcinoma / Curr Opin Oncol 29 : 25 ~ 32

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