Primary Squamous Cell Carcinoma of the Thyroid

Abstract

Background: Primary squamous cell carcinoma of the thyroid (PSCCT) is a rare malignancy of the head and neck, with fewer than 60 cases reported in the literature. We report a case of PSCCT and provide a brief review of the literature. Case Report: A 66-year-old female with a history of a hemithyroidectomy for a benign thyroid lesion presented with 3 months of progressively worsening compressive symptoms and shortness of breath. Physical examination revealed right-sided thyromegaly and right-sided true vocal fold immobility. Preoperative imaging with ultrasound and computed tomography scan confirmed an enlarged right thyroid, as well as right anterior cervical lymphadenopathy, subglottic stenosis, and bilateral pulmonary nodules. Fine needle aspiration of the thyroid was suggestive of carcinoma. Intraoperative findings of gross tracheal invasion during a planned completion thyroidectomy prompted limited resection and impromptu tracheotomy. Histopathologic and immunohistochemical evaluation confirmed a squamous cell carcinoma of thyroid origin. Further oncologic workup with core lung biopsy and positron emission tomography scan demonstrated metastasis to the lung and cervical spine. Palliative chemotherapy was begun, but the patient died 1 week into therapy. Conclusion: PSCCT is a rare but aggressive malignancy of the head and neck. Histopathologic and immunohistochemical evaluations are essential for diagnosis. While locoregional surgery and radiation therapy may improve the length of survival, the prognosis of patients with PSCCT is poor. Physicians should be mindful of this unique but deadly disease process, as early diagnosis and rapid treatment initiation are essential to optimize treatment outcomes.

Ultrasonic Characterization of Primary Squamous Cell Carcinoma of the Thyroid

“…PSCCT has been reported to be combined with HT and other thyroid malignancies, 11,13–16 which supports the second theory. However, the origin of most cases, including the remaining PSCCTs in our study and the ones reported in other studies 1,4,17 remains unclear, indicating that the origin of PSCCT requires further investigation.…”

“…The most common clinical symptom was rapid swelling neck, followed by compressive symptoms such as hoarseness, dysphagia and dyspnea, consistent with other studies. 4,18 The mean size of PSCCTs was about 3.87 cm, ranging from 1.0 to 6.0 cm, relatively larger than the average size of general thyroid cancers. 19 This might be due to the aggressive nature of PSCCT and the rapid growth of tumor cells.…”

Primary squamous cell carcinoma of the thyroid: a case report

“… 1 Fewer than 60 cases of PSCCT have been reported in the medical literature. 2 PSCCT has been characterized as an extremely aggressive tumor with a poor prognosis, and survival is often shorter than 1 year. 3 The low incidence of PSCCT has impeded clinical research and the development of evidence-based diagnostic algorithms and treatment guidelines.…”

Contrast-Enhanced Ultrasound of Primary Squamous Cell Carcinoma of the Thyroid: A Case Report

“…Primary squamous cell carcinoma of the thyroid (ThyPSCC) is a rare thyroid malignancy with high aggressiveness and poor prognosis, comprising ∼0.1-1% of all primary thyroid carcinomas (1)(2)(3)(4)(5)(6). Owing to the rapidly progressing and highly invasive nature of the malignancy, patients with ThyPSCC often present at an advanced stage and are difficult to diagnose in the early stage because of its rare incidence and lack of typical imaging findings (7,8).…”