Aggressive thyroid carcinoma mimicking a benign histiocytic proliferation - Utility of tumor markers to approach diagnosis

8^th International Conference on Endocrinology, Diabetes and Metabolism

March 23, 2023 | Webinar

Beverly Y Wang

UC Irvine Medical Center, USA

Posters & Accepted Abstracts: J Endocr Disord Surg

Abstract :

Background: It is unusual for a malignant neoplasm to have morphologic resemblance to a benign disorder. We present a case of an unusual clinically aggressive thyroid carcinoma that morphologically mimicked a benign entity. Clinical History: A 58-year-old Vietnamese woman underwent a partial thyroidectomy followed by radioactive iodine 131 ablation for a “medullary thyroid cancer”. Two months later, tissue samples failed to disclose a recurrence of the tumor. CT scan revealed a large thyroid mass with hemorrhage encroaching the trachea and bilateral pulmonary nodules consistent with metastasis. She underwent repeat neck exploration and hematoma evacuation. This surgical specimen had a benign appearing histiocytic proliferation with a high proliferative index (Ki-67 of 20%). A repeat review of the previous tissue sample showed a microscopic focus of thyroid follicles that merged imperceptibly into adjacent areas of foamy histiocytic proliferation. The final diagnosis was a poorly differentiated thyroid carcinoma. Although the patient was treated with chemotherapy concurrent with radiation, she rapidly deteriorated and succumbed to her illness. Summary: To our knowledge, this report represents a rare case of an aggressive poorly differentiated thyroid carcinoma variant mimicking a benign histiocytic proliferation. Conclusion: A malignant tumor mimicking a benign tissue has grave implications for patient care. Careful review of tissue samples and appropriate use of biomarkers to achieve accurate diagnosis is paramount to providing best oncologic care.

Biography :

Beverly Wang is a professor of University of California School of Medicine at Irvine. She received her training at Mount Sinai Medical Center, New York, also completing a cytopathology fellowship. She is a general surgical pathologist, specializing in head and neck. She is vice chair of pathology and laboratory medicine, and chief of anatomic pathology, overseeing anatomic pathology services. Her clinical interests include translational research, correlating head and neck diseases, and tumors. Wang has published extensively. She has been awarded a number of prestigious honors and has consistently been named one of “America’s Top Doctors.”.