Abstract
Background: Columnar cell carcinoma is a rare subtype of papillary thyroid carcinoma (CCV-PTC) that accounts for only 0.15% to 0.2% of all Papillary Thyroid Carcinomas (PTCs). It has aggressive behavior but a better prognosis than anaplastic thyroid carcinoma.
Case Presentation: A 64-year-old female presented with a huge thyroid mass resulting in compressive myelopathy and was diagnosed as CCV-PTC, not anaplastic carcinoma. After multidisciplinary discussions, we decided to proceed with otolaryngological, thoracic, and orthopaedic surgery. All tumours were unresectable, and we planned to proceed with R2 resection to resolve the gait disturbance and anterior fusion to resolve spinal instability.
Conclusion: Advanced-stage thyroid cancer is relatively uncommon, but desirable treatment effects can be expected through accurate pathological diagnosis. Immunohistochemical staining and tissue-specific markers can be helpful.
[1]
Benvenga S. Thyroid gland: anatomy and physiology.Encyclopedia of Endocrine Diseases. 2018; 4: pp. 382-90.
[2]
Sywak M, Pasieka JL, Ogilvie T. A review of thyroid cancer with intermediate differentiation. J Surg Oncol 2004; 86(1): 44-54.
[http://dx.doi.org/10.1002/jso.20044] [PMID: 15048680]
[http://dx.doi.org/10.1002/jso.20044] [PMID: 15048680]
[3]
Lee JH, Shin JH, Lee HW, Oh YL, Hahn SY, Ko EY. Sonographic and cytopathologic correlation of papillary thyroid carcinoma variants. J Ultrasound Med 2015; 34(1): 1-15.
[http://dx.doi.org/10.7863/ultra.34.1.1] [PMID: 25542934]
[http://dx.doi.org/10.7863/ultra.34.1.1] [PMID: 25542934]
[4]
Cameselle-Teijeiro JM, Eloy C, Sobrinho-Simões M. Pitfalls in challenging thyroid tumors: emphasis on differential diagnosis and ancillary biomarkers. Endocr Pathol 2020; 31(3): 197-217.
[http://dx.doi.org/10.1007/s12022-020-09638-x] [PMID: 32632840]
[http://dx.doi.org/10.1007/s12022-020-09638-x] [PMID: 32632840]
[5]
Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid 2016; 26(1): 1-133.
[http://dx.doi.org/10.1089/thy.2015.0020] [PMID: 26462967]
[http://dx.doi.org/10.1089/thy.2015.0020] [PMID: 26462967]
[6]
Chen JH, Faquin WC, Lloyd RV, Nosé V. Clinicopathological and molecular characterization of nine cases of columnar cell variant of papillary thyroid carcinoma. Mod Pathol 2011; 24(5): 739-49.
[http://dx.doi.org/10.1038/modpathol.2011.2] [PMID: 21358618]
[http://dx.doi.org/10.1038/modpathol.2011.2] [PMID: 21358618]
[7]
Cho J, Shin JH, Hahn SY, Oh YL. Columnar cell variant of papillary thyroid carcinoma: ultrasonographic and clinical differentiation between the indolent and aggressive types. Korean J Radiol 2018; 19(5): 1000-5.
[http://dx.doi.org/10.3348/kjr.2018.19.5.1000] [PMID: 30174490]
[http://dx.doi.org/10.3348/kjr.2018.19.5.1000] [PMID: 30174490]
[8]
Hundahl SA, Fleming ID, Fremgen AM, Menck HR. A National Cancer Data Base report on 53,856 cases of thyroid carcinoma treated in the U.S., 1985-1995. Cancer 1998; 83(12): 2638-48.
[http://dx.doi.org/10.1002/(SICI)1097-0142(19981215)83:12<2638::AID-CNCR31>3.0.CO;2-1] [PMID: 9874472]
[http://dx.doi.org/10.1002/(SICI)1097-0142(19981215)83:12<2638::AID-CNCR31>3.0.CO;2-1] [PMID: 9874472]
[9]
Ho AS, Luu M, Barrios L, et al. Incidence and mortality risk spectrum across aggressive variants of papillary thyroid carcinoma. JAMA Oncol 2020; 6(5): 706-13.
[http://dx.doi.org/10.1001/jamaoncol.2019.6851] [PMID: 32134428]
[http://dx.doi.org/10.1001/jamaoncol.2019.6851] [PMID: 32134428]
[10]
Wang S, Xiong Y, Zhao Q, Song H, Yi P, Liu C. Columnar cell papillary thyroid carcinoma prognosis: findings from the SEER database using propensity score matching analysis. Am J Transl Res 2019; 11(9): 6262-70.
[PMID: 31632592]
[PMID: 31632592]
[11]
Crescenzi A, Baloch Z. Immunohistochemistry in the pathologic diagnosis and management of thyroid neoplasms. Front Endocrinol (Lausanne) 2023; 141198099
[http://dx.doi.org/10.3389/fendo.2023.1198099] [PMID: 37324272]
[http://dx.doi.org/10.3389/fendo.2023.1198099] [PMID: 37324272]
[12]
Enriquez ML, Baloch ZW, Montone KT, Zhang PJ, LiVolsi VA. CDX2 expression in columnar cell variant of papillary thyroid carcinoma. Am J Clin Pathol 2012; 137(5): 722-6.
[http://dx.doi.org/10.1309/AJCPXE3PUBWVZCGZ] [PMID: 22523209]
[http://dx.doi.org/10.1309/AJCPXE3PUBWVZCGZ] [PMID: 22523209]
[13]
Bai Y, Kakudo K, Jung CK. Updates in the pathologic classification of thyroid neoplasms: a review of the World Health Organization classification. Endocrinol Metab (Seoul) 2020; 35(4): 696-715.
[http://dx.doi.org/10.3803/EnM.2020.807] [PMID: 33261309]
[http://dx.doi.org/10.3803/EnM.2020.807] [PMID: 33261309]
[14]
Li Y. Total versus subtotal thyroidectomy for differentiated thyroid carcinoma and their influence on related indexes. Int J Clin Exp Med 2020; 13(10): 8007-13.
[15]
Ragazzi M. Update on anaplastic thyroid carcinoma: morphological, molecular, and genetic features of the most aggressive thyroid cancer. Int J Endocrinol 2014; 2014
[http://dx.doi.org/10.1155/2014/790834]
[http://dx.doi.org/10.1155/2014/790834]
[16]
Xu B, Fuchs T, Dogan S, et al. Dissecting anaplastic thyroid carcinoma: a comprehensive clinical, histologic, immunophenotypic, and molecular study of 360 cases. Thyroid 2020; 30(10): 1505-17.
[http://dx.doi.org/10.1089/thy.2020.0086] [PMID: 32284020]
[http://dx.doi.org/10.1089/thy.2020.0086] [PMID: 32284020]
[17]
Gjeluci A, Clark J, Jawahar A. Rare columnar cell variant papillary thyroid carcinoma with metastasis to pancreas and lungs at initial presentation: A case report and review of literature. J Gastroint Abdom Radiol 2022; 6(01): 062-6.
[18]
Mulita F, Theofanis G, Verras GI, et al. Comparison of postoperative bleeding using harmonic scalpel and LigaSure in thyroid surgery: a 15-year single-centre retrospective study. Med Glas 2023; 20(2)
[PMID: 37585298]
[PMID: 37585298]
