Primary Mucoepidermoid Carcinoma of the Thyroid: A Report of a Rare Case with Bone Metastasis and Review of the Literature

Le, Quang Van; Ngo, Duy Quoc; Ngo, Quy Xuan

doi:10.1159/000498917

Cited by 14 publications

(15 citation statements)

References 13 publications

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“…Most cases of thyroid MEC exhibit an indolent disease course with an excellent prognosis and disease-specific survival exceeding 10 years 16. Despite this, there are 10 reported cases of aggressive disease progression with patients presenting with extrathyroidal tumour invasion and/or distant metastases resulting in death within 12 months of diagnosis 22 23. Currently, there is no established treatment algorithm for thyroid MEC in view of its rarity.…”

Section: Discussionmentioning

confidence: 99%

Synchronous mucoepidermoid carcinoma and papillary microcarcinomas of the thyroid gland

et al. 2022

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Thyroid mucoepidermoid carcinoma (MEC) is a rare thyroid malignancy first documented in 1977. The majority of thyroid MECs are indolent, low-grade tumours with excellent prognosis. A woman in her 60s presented with an ongoing sensation of a lump in the left neck. There were no swallowing, voice or airway concerns. Ultrasound of the neck showed an enlarged thyroid with U5 and U3 features on the right and left lobes, respectively. Right fine needle aspiration cytology (FNAC) demonstrated certain features of Hurthle cell or anaplastic carcinoma (Thy5). Left FNAC showed Hurthle cell changes with atypical cells and prominent nucleoli (Thy3a). Following total thyroidectomy, histopathology revealed synchronous right low-grade MEC and left papillary thyroid microcarcinomas (pT2(m) N0 M0) on a background of Hashimoto’s thyroiditis. This case adds to the literature and details the key histopathological features for a rare but important differential in patients with thyroid carcinoma due to synchronous histological types.

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Section: Discussionmentioning

confidence: 99%

Synchronous mucoepidermoid carcinoma and papillary microcarcinomas of the thyroid gland

et al. 2022

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“…Thyroidal MEC is a rare malignant neoplasm, with only 49 reported cases to date [ 4 ]. Commonly, this rare malignant tumor is considered low-grade, but several cases with poor outcomes have also been reported [ 1 , 4 ]. Herein, a very rare case of primary thyroid high-grade MEC with a poor prognosis has been described.…”

Section: Discussionmentioning

confidence: 99%

“…In the thyroid, MECs are rare malignant neoplasms, accounting for 0.5% of thyroid malignancies, with approximately 49 cases reported in the English literature [4]. Patients are aged 10 to 91 years and predominantly female [1]. The origin of MECs in the thyroid gland is unclear; however, thyroid follicular epithelium [10] or solid cell nests [11] are regarded as suspicious candidates.…”

Section: Discussionmentioning

confidence: 99%

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High-grade mucoepidermoid carcinoma in the thyroid gland with poor prognosis

Shin

2021

Yeungnam Univ J Med

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Mucoepidermoid carcinoma (MEC) is the most common malignant neoplasm of the salivary gland, but primary thyroid MEC has rarely been reported and usually has a good prognosis. Herein, I report a case of thyroidal MEC with a poor prognosis in an 82-year-old woman with an anterior neck mass. Ultrasonography and computed tomography revealed a thyroid mass. The patient initially underwent fine-needle aspiration, was diagnosed with malignancy, and underwent a right lobectomy. On gross examination, a 4.0×3.6×2.6 cm-sized ill-defined, unencapsulated, and infiltrative tan to whitish mass with necrosis was identified. Microscopically, epidermoid tumor cell nests or solid sheets were identified. Mucous cells that were positive for periodic acid–Schiff and mucicarmine stains were also identified within epidermoid cell nests. Frequent mitosis and necrosis were observed. Immunohistochemical staining for p40 and p63 was positive, and that for thyroid transcription factor-1 and paired box gene 8 was focally positive. According to the Armed Forces Institute of Pathology grading system for salivary gland MEC, the current case was classified as high-grade MEC. After surgery, the patient suffered from dyspnea due to a remnant neck mass that compressed and obstructed the trachea; therefore, the patient refused further treatment. Thyroidal MECs are considered low-grade with a favorable prognosis, but there are several reported cases of thyroidal MEC with poor prognosis. The current case is a rare presentation of high-grade thyroidal MEC with a poor prognosis.

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“…Mucoepidermoid carcinoma and sclerosing mucoepidermoid carcinoma with eosinophilia are rare carcinomas of thyroid gland with both epidermoid and mucin differentiation (Shah et al 2017, Le et al 2019. The epidermoid component, if predominant, could mimic primary squamous cell carcinoma of thyroid.…”

Section: Differential Diagnosesmentioning

confidence: 99%

Squamous cell carcinoma of thyroid: a unique type of cancer in World Health Organization Classification

Lam

2020

Endocrine-Related Cancer

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The aim is to review the features of 117 primary squamous cell carcinomas of thyroid which meet the histological criteria of the World Health Organization classification of endocrine tumours. The carcinomas occur in 83 women and 34 men (female to male ratio is 2.4 to 1) and with median age at presentation of 64. Half of these squamous cell carcinomas of thyroid were moderately differentiated. PAX-8 protein is a sensitive marker for confirming the thyroid origin of the carcinoma. The carcinoma is also positive for p63, p40, cytokeratins 5/6, 7,19 and negative for cytokeratins 20 and 10/13. P53 overexpression is common. The most important differential diagnosis is direct infiltration or metastatic involvement by squamous cell carcinoma from other organs. Limited mutation analysis revealed BRAF mutation in some squamous cell carcinomas of the thyroid. The genetic profile appears to be different from anaplastic thyroid carcinomas. Primary squamous cell carcinoma of thyroid had lymph node involvement in 59% and distant metastases in 26%. The median survival of the patients was 8 months. Curative surgery offers the best survival for the patients with the carcinoma. To conclude, primary squamous cell carcinoma of the thyroid gland has distinctive clinical, pathological and molecular profiles. It is important to recognize this unique variant of thyroid carcinoma for possible curative surgical resection and to do more genomic works on the entity to uncover the molecular pathogenesis.

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Primary Mucoepidermoid Carcinoma of the Thyroid: A Report of a Rare Case with Bone Metastasis and Review of the Literature

Cited by 14 publications

References 13 publications

Synchronous mucoepidermoid carcinoma and papillary microcarcinomas of the thyroid gland

Synchronous mucoepidermoid carcinoma and papillary microcarcinomas of the thyroid gland

High-grade mucoepidermoid carcinoma in the thyroid gland with poor prognosis

Squamous cell carcinoma of thyroid: a unique type of cancer in World Health Organization Classification

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