Primary Squamous Cell Carcinoma of the Thyroid with Severe Tracheal Invasion: A Case Report

Iwamoto, Yuichiro; Anno, Takatoshi; Koyama, Katsumasa; Ota, Yusuke; Nakashima, Kenichiro; Monobe, Yasumasa; Kaneto, Hideaki; Okimoto, Niro; Tomoda, Koichi

doi:10.1159/000511709

Cited by 3 publications

(5 citation statements)

References 3 publications

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“…Primary squamous cell carcinoma of thyroid (PSCCT) is a highly aggressive rare tumor (<1%), having a poor prognosis with a median survival time of about 9-12 months and less clearly defined therapy due to its rarity [1]. Fewer cases have been reported in the literature.…”

Section: Discussionmentioning

confidence: 99%

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Paraneoplastic Manifestation of Primary Squamous Cell Cancer of the Thyroid Gland

Sharma.P.S,

B.V

et al. 2023

Cureus

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Paraneoplastic manifestation (PNM) of cancers is a non-metastatic, non-invasive systemic effect of malignancies due to chemokines and hormones produced by the primary neoplasm. Squamous cell cancers (SCCs) are known to present with PNM. Primary SCC of thyroid accounts for <1% of all thyroid malignancies and carries a very poor prognosis. We present a rare case of SCC arising from the thyroid gland who presented with fever, leukemoid reaction and hypercalcemia as part of PNM. A 67-year-old male patient presented with two months history of intermittent high-grade fever, weakness, loss of weight and appetite. Examination revealed a large (~10 cm) hard swelling over the right side of the neck. Investigations revealed neutrophilic leukocytosis, elevated C-reactive protein (CRP) and procalcitonin and hypercalcemia with a normal thyroid-stimulating hormone (TSH). The fever workup was negative for infection. Fine-needle aspiration cytology (FNAC) and core biopsy of the thyroid mass revealed malignant cells with squamous differentiation. An extensive search for possible other primary was ruled out by triple endoscopy. The combination of fever, neutrophilic leukocytosis, hypercalcemia and squamous malignancy was consistent with a diagnosis of PNM of SCC. A fluorodeoxyglucose-positron emission tomography (FDG-PET) CT scan showed a heterogeneously enhancing mass lesion in the right lobe of the thyroid with some retrosternal extension. He underwent total thyroidectomy with bilateral central compartment neck dissection. Final histopathology revealed moderately differentiated SCC of the thyroid. Concurrent chemoradiation was given. Despite continued chemotherapy, he succumbed to illness within six months of diagnosis. Primary SCC of thyroid (PSCCT) is a rare malignancy. It is a highly aggressive tumor having a poor prognosis with a median survival time of about 9-12 months and less clearly defined therapy due to its rarity. Paraneoplastic manifestation of PSCCT is known. As fever, leukemoid reaction and hypercalcemia can be a paraneoplastic manifestation, one should think of PSCCT.

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Section: Discussionmentioning

confidence: 99%

“…Primary squamous cell carcinoma of thyroid (PSCCT) is a rare and aggressive malignancy. It accounts for <1% of all thyroid malignancies and carries a very poor prognosis [1]. It usually presents as enlarging mass in the neck region with compression symptoms.…”

Section: Introductionmentioning

confidence: 99%

Paraneoplastic Manifestation of Primary Squamous Cell Cancer of the Thyroid Gland

Sharma.P.S,

B.V

et al. 2023

Cureus

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“…Molecular alterations have also recently been identified, which led to changes in the WHO classification of PSCC of the thyroid from its own separate entity to a subtype of anaplastic thyroid carcinoma in 2022. In a recent multi-institutional study of over 300 patients from two tertiary centers, PSCC not only had a similar outcome to anaplastic thyroid carcinoma but also displayed the BRAFV600E mutations in 87.5% of cases, regardless of thyroid differentiation status [ 8 , 9 ]. Our patient was diagnosed in August 2019 and passed away in February 2021 and, unfortunately, no molecular analysis was performed.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, positive PAX-8 staining in a squamous cell carcinoma involving the thyroid strongly supports a primary thyroid origin in much the same way p16 stains positive in HPV-related oropharyngeal squamous cell carcinomas. Interestingly, partial p16 positivity has also been described for PSCC [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…Some patients have a history of goiter or thyroid diseases including Hashimoto's thyroiditis [2]. Thought to have arisen from either undifferentiated follicular cells, metaplastic follicular epithelium, or a thyroglossal duct remnant [3][4][5][6][7], the World Health Organization (WHO) has now classified PSCC as a subtype of anaplastic carcinoma due to similar poor prognosis and molecular alteration [8,9].…”

Section: Introductionmentioning

confidence: 99%

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Primary squamous cell carcinoma of the thyroid treated with concurrent chemoradiation and palliative immunotherapy: a case report

et al. 2022

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Background Primary squamous cell carcinoma of the thyroid is a very rare malignancy with aggressive growth and poor prognosis. There is currently no consensus for treatment modality, however, most patients with primary squamous cell carcinoma of the thyroid are treated with surgery and adjuvant chemoradiation. Case presentation We report a rare case of primary squamous cell carcinoma of the thyroid in a 68-year-old White male who underwent chemoradiation and palliative immunotherapy after declining surgery. He was treated with intensity-modulated radiation therapy to 70 Gy in 35 fractions, with concurrent carboplatin–paclitaxel and palliative pembrolizumab. Local thyroid disease recurrence occurred at 6 months post-chemoradiation, and the patient died at 16 months post-chemoradiation. Conclusions This is the first case report demonstrating the use of pembrolizumab as palliative therapy for primary squamous cell carcinoma of the thyroid. Our study also highlights the importance of chemoradiation in decreasing primary mass size and immunotherapy in preventing metastatic disease progression.

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Progress in diagnosing and treating thyroid squamous cell carcinoma under the 5th edition of WHO classification

Ding,

Gao,

Ran

2024

Front. Endocrinol.

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Squamous cell carcinoma of the thyroid (SCCT) is a rare thyroid gland malignancy, with only a few hundred cases reported in the literature, mostly as case reports or small sample studies. In the previous WHO classification, squamous cell carcinoma of the thyroid was defined as a carcinoma composed entirely of squamous cells without differentiated carcinoma components. It was once included in the WHO tumor classification separately. However, the 2022 WHO classification of squamous cell carcinoma of the thyroid was reclassified as a morphologic subtype of anaplastic thyroid carcinoma (ATC). The squamous cell carcinoma pattern is similar to the other histologic types of ATC, but the phenotype associated has a poorer prognosis. The typical clinical manifestation of this condition is a cervical mass, accompanied by indications and symptoms of compression on adjacent structures such as the esophagus and trachea in advanced stages. Secondary squamous cell carcinoma of the thyroid may occur due to the spread of squamous carcinoma of the larynx or esophagus or distant metastases from other sites. Diagnosis of squamous cell carcinoma of the thyroid includes neck Ultrasound (US), Computed Tomography (CT) or Magnetic Resonance Imaging (MRI), puncture tissue biopsy, and full endoscopy to identify metastatic lesions from the nasopharynx, oropharynx, hypopharynx, larynx, esophagus, or bronchi and to help with the initial staging of the tumor. Current treatment modalities include surgery, radiotherapy, chemotherapy, or a combination. Because of the poor prognosis of patients with this disease, the short survival period, usually less than one year, and the difficulty of preoperative diagnosis, this article reviews the epidemiological features, origin, clinical features, pathological features, and differential diagnosis to improve the diagnosis and treatment of this disease by clinicians.

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Primary Squamous Cell Carcinoma of the Thyroid with Severe Tracheal Invasion: A Case Report

Cited by 3 publications

References 3 publications

Paraneoplastic Manifestation of Primary Squamous Cell Cancer of the Thyroid Gland

Paraneoplastic Manifestation of Primary Squamous Cell Cancer of the Thyroid Gland

Primary squamous cell carcinoma of the thyroid treated with concurrent chemoradiation and palliative immunotherapy: a case report

Progress in diagnosing and treating thyroid squamous cell carcinoma under the 5th edition of WHO classification

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