Mixed medullary‐papillary carcinoma of the thyroid: Report of a case and review of the literature

Nangue, Charlette; Bron, Luc; Portmann, Luc; Volante, Marco; Ris, Hans‐Beat; Monnier, Philippe; Andrejevic‐Blant, Snezana

doi:10.1002/hed.20984

Cited by 33 publications

(31 citation statements)

References 14 publications

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“…The authors suggested that another gene or uncommon abnormality of the RET gene was responsible for tumorgenesis. A recent animal study by Miller and colleagues [22,23] suggested that the PI3K or Ras signaling cascade alone was unable to transform thyroid follicular cells but that simultaneous activation had invasive and metastatic potential. Overall, the molecular evidence suggested that the two components of these heterogeneous groups of tumors were not derived from a common stem cell [23,24].…”

Section: Discussionmentioning

confidence: 99%

“…A recent animal study by Miller and colleagues [22,23] suggested that the PI3K or Ras signaling cascade alone was unable to transform thyroid follicular cells but that simultaneous activation had invasive and metastatic potential. Overall, the molecular evidence suggested that the two components of these heterogeneous groups of tumors were not derived from a common stem cell [23,24]. The origin of each carcinoma is embryologically different because the C cells stem from an ultimobranchial body that derived from the fourth pharyngeal pouch, whereas the thyroglobulin and thyroid hormone-producing cells come from the follicular epithelial cells derived from a median endodermal anlage from the tongue.…”

Section: Discussionmentioning

confidence: 99%

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Medullary and papillary carcinoma of the thyroid gland occurring as a collision tumor with lymph node metastasis: A case report

Alavi

Azarpira

2011

J Med Case Reports

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IntroductionPapillary thyroid carcinoma and medullary thyroid carcinoma are two different thyroid neoplasia. The simultaneous occurrence of medullary thyroid carcinoma and papillary thyroid carcinoma as a collison tumor with metastases from both lesions in the regional lymph nodes is a rare phenomenon.Case presentationA 32-year-old Iranian man presented with a fixed anterior neck mass. Ultrasonography revealed two separate thyroid nodules as well as a suspicious neck mass that appeared to be a metastatic lesion. The results of thyroid function tests were normal, but the preoperative calcitonin serum value was elevated. Our patient underwent a total thyroidectomy with neck exploration. Two separate and ill-defined solid lesions grossly in the right lobe were noticed. Histological and immunohistochemical studies of these lesions suggested the presence of medullary thyroid carcinoma and papillary thyroid carcinoma. The lymph nodes isolated from a neck dissection specimen showed metastases from both lesions.ConclusionsThe concomitant occurrence of papillary thyroid carcinoma and medullary thyroid carcinoma and the exact diagnosis of this uncommon event are important. The treatment strategy should be reconsidered in such cases, and genetic screening to exclude multiple endocrine neoplasia 2 syndromes should be performed. For papillary thyroid carcinoma, radioiodine therapy and thyroid-stimulating hormone suppressive therapy are performed. However, the treatment of medullary thyroid carcinoma is mostly radical surgery with no effective adjuvant therapy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Medullary and papillary carcinoma of the thyroid gland occurring as a collision tumor with lymph node metastasis: A case report

Alavi

Azarpira

2011

J Med Case Reports

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“…Most reports of thyroid carcinomas are of either the medullary or papillary type. Mixed medullary-papillary carcinomas were first described in the early 1980s; (6) Lax et al (7) reported three cases in 1994, while Papotti et al (8) described an important series of 11 cases of mixed medullary-follicular cell thyroid carcinomas in 1997. In MTCs, which account for about 5%-8% of all thyroid carcinomas, (2) 3%-5% of the cases may display mixed features, with either a follicular or papillary component in the primary tumour, metastases, or both.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous medullary carcinoma, papillary carcinoma and granulomatous inflammation of the thyroid

Kataria¹,

Yadav²,

Sarkar³

et al. 2013

smedj

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We report a case of a collision tumour occurring in the right thyroid lobe. The collision tumour had lesions with features of MTC and PTC at two different locations that were separated by normal thyroid tissue. In addition, a separate focus of papillary carcinoma in the left thyroid lobe, C-cell hyperplasia with granulomatous inflammation in the right thyroid lobe and metastasis of the medullary component to the right neck lymph nodes were also seen. To the best of our knowledge, this is the first report of such a combination of features. CA S E R E PO RTA 35-year-old man presented with complaints of a slowgrowing left thyroid swelling that had persisted for six months. He had no symptoms of hypo-or hyperthyroidism, dysphagia, voice change, abdominal pain, irradiation in the head and neck region, or a family history of thyroid cancer.He had a history of pulmonary tuberculosis one year before presentation.Examination revealed a small, firm-to-hard, non-tender ABSTRACT Thyroid tumours with both papillary and medullary carcinoma features are rare and represent less than 1% of all thyroid malignancies. These tumours have a different clinical presentation and biological behaviour from tumours that have only papillary or medullary carcinoma features. The phenomenon of mixed thyroid tumours can be observed in two settings -a mixed tumour showing dual differentiation, or a collision tumour. For a precise diagnosis of this rare mixed thyroid carcinoma, fine needle aspiration cytology results should be correlated with serum calcitonin and thyroglobulin levels. The diagnosis should also be confirmed using immunocytochemistry. Surgery is the treatment of choice, and the role of postoperative radioiodine is controversial. We herein report the case of a 35-year-old man with a mixed medullary-papillary carcinoma of the thyroid, which presented with C-cell hyperplasia, granulomatous inflammation and metastasis to the cervical lymph nodes. The patient was treated with total thyroidectomy and nodal clearance. This case highlights the need for awareness of coexistent entities as they warrant separate treatments.

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“…The association of a mixed tumor (medullary along with papillary thyroid cancer) is very rare and has not been described before in association with MEN 2A. [56789]…”

Section: Discussionmentioning

confidence: 99%

Simultaneous presentation of giant pheochromocytoma, primary hyperparathyroidism, and mixed-medullary-papillary thyroid cancer in MEN 2A

Gupta

2013

Indian J Endocr Metab

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The aim of this study was to describe a young man with probably the largest pheochromocytoma associated with MEN 2A, described till date. The patient, a non-vegetarian, fifth of eight siblings, married, having five children, presented with episodes of difficult-to-control hypertension requiring over five antihypertensives. He was referred to us with an abdominal CT scan that revealed a 16 cm left-sided adrenal mass. Biochemical testing confirmed a catecholamine secreting pathology. Histopathology confirmed the mass as a pheochromocytoma weighing 1.8 kg. Further evaluation suggested a parathormone-dependent hypercalcemia and a left-sided thyroid mass. Histopathology confirmed parathyroid hyperplasia and medullary carcinoma of the thyroid mixed with papillary carcinoma of thyroid. Putting all the findings together showed that the patient was suffering from multiple endocrine neoplasia 2. Multiple endocrine neoplasia 2A is a rare syndrome. The case is unique in the way it presented, with all the three tumors at the same time. The management was bold and addressed all the three lesions in the same hospital admission. We are also reporting the largest described case of pheochromocytoma from India.

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Mixed medullary‐papillary carcinoma of the thyroid: Report of a case and review of the literature

Cited by 33 publications

References 14 publications

Medullary and papillary carcinoma of the thyroid gland occurring as a collision tumor with lymph node metastasis: A case report

Medullary and papillary carcinoma of the thyroid gland occurring as a collision tumor with lymph node metastasis: A case report

Simultaneous medullary carcinoma, papillary carcinoma and granulomatous inflammation of the thyroid

Simultaneous presentation of giant pheochromocytoma, primary hyperparathyroidism, and mixed-medullary-papillary thyroid cancer in MEN 2A

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