Successful Management of a Patient with Malignant Thyroid Teratoma

Rabinowits, Guilherme; Barletta, Justine A.; Sholl, Lynette M.; Reche, Encarnación; Lorch, Jochen H.; Goguen, Laura A.

doi:10.1089/thy.2016.0201

Cited by 20 publications

(30 citation statements)

References 16 publications

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“…However, in most cases, the primitive nature of the malignant cells is not apparent by FNA, and the correct diagnosis has never been suggested in previous reports (Table ). On the other hand, abundant immature neuroepithelium is the defining feature of malignancy in resection specimens . As in the current case, immature neuroepithelium usually greatly predominates, sometimes to the extent that tissue from other germ cell lines may be difficult to find (Table ).…”

Section: Discussionmentioning

confidence: 99%

“…Cases of malignant thyroid teratoma described prior to the use of effective therapy were generally associated with an overall poor outcome and a median survival of about 8 months. More recently, the use of cis‐platinum based chemotherapy regimens such as those used for germ cell tumors in other sites have been dramatically more successful and, when combined with radiation therapy, can result in long‐term disease‐free survival …”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, abundant immature neuroepithelium is the defining feature of malignancy in resection specimens. 1,[5][6][7][8][9][10][11][12][13][14] As in the current case, immature neuroepithelium usually greatly predominates, sometimes to the extent that tissue from other germ cell lines may be difficult to find (Table 1). IHC studies can be helpful to confirm neuronal differentiation, as well as to detect minor foci of ectodermal or mesodermal elements.…”

Section: Case Reportmentioning

confidence: 99%

“…More recently, the use of cis-platinum based chemotherapy regimens such as those used for germ cell tumors in other sites have been dramatically more successful and, when combined with radiation therapy, can result in long-term disease-free survival. 9,14 In summary, it is important to be aware that malignant teratoma may rarely present as a thyroid nodule. Recognition by FNA is challenging, and appreciation of neuroendocrine-appearing features, coupled with the selected use of ancillary studies, will be required for cytologic identification.…”

Section: Case Reportmentioning

confidence: 99%

“…2 In previous case reports of primary malignant teratoma with FNA findings, patients have ranged in age from 13 to 64 years old, and as with most other thyroid malignancies, the majority were female. 1,5,[7][8][9][10][11][12][13][14] Given the germ cell origin of thyroid teratomas, and the overall rarity of these tumors, it is interesting that four cases have been previously reported during pregnancy 15 ; all were malignant.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Malignant teratoma of the thyroid: A difficult diagnosis by fine‐needle aspiration

Starling¹,

Sabra²,

Brady³

et al. 2019

Diagnostic Cytopathology

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Primary thyroid teratomas are rare, usually benign, and typically occur in children. We report the unusual occurrence of a malignant thyroid teratoma in a young man. Initial ultrasound and CT studies revealed an 8.5 heterogeneous mass involving the entire right thyroid lobe causing tracheal compression and deviation. Fine‐needle aspiration (FNA) revealed malignant cells with possible neuroendocrine features. Similar findings have been previously reported, with an occasional interpretation as possible medullary thyroid carcinoma. In no report, as with our case, has the correct diagnosis been suggested with FNA. The surgical specimen contained abundant primitive neuroepithelium with a very minor component of mature ectodermal tissue in one area. Like this case, an abundance of immature neuroepithelium has been reported in essentially all previous reports of primary malignant thyroid teratoma, sometimes creating a challenge to find another type of germ cell tissue. Array comparative genomic hybridization studies in this case revealed a markedly complex karyotype including gain of chromosome 12 and loss of 17p. Amplification of MYCN, EWSR1 rearrangement and isochromosome 12p were not identified, providing no evidence for neuroblastoma or Ewing sarcoma/peripheral neuroectodermal tumor, both of which have also rarely been reported as primary thyroid tumors. With the use of cisplatinum‐based chemotherapy combined with radiation, survival times have increased dramatically. Our patient is now disease free and back to his normal activities after relatively short follow‐up. Although rare, it is important to be aware that teratomas may present as a thyroid nodule. Recognition by FNA is challenging, and requires multiple modalities for full identification.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Malignant teratoma of the thyroid: A difficult diagnosis by fine‐needle aspiration

Starling¹,

Sabra²,

Brady³

et al. 2019

Diagnostic Cytopathology

View full text Add to dashboard Cite

show abstract

Thyroblastoma: A DICER1‐associated embryonal neoplasm and fine needle aspiration diagnostic criteria

Jitpasutham

Faquin

Torous

et al. 2023

Diagnostic Cytopathology

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Thyroblastoma is a rare, aggressive embryonal thyroid neoplasm associated with DICER1 mutation. It usually presents as a rapidly growing thyroid mass diffusely infiltrating the thyroid lobes and extending into perithyroidal tissue. Most thyroblastomas were initially diagnosed as malignant teratoma or carcinosarcoma. The cytologic features of thyroblastoma have not been well documented. Here, we present the cytological findings of a case of thyroblastoma in a 19‐year‐old female with a dominant solid left thyroid nodule. A fine needle aspiration biopsy of the mass revealed a highly cellular aspirate composed of crowded, atypical, high nuclear to cytoplasmic ratio epithelial cells, arranged in a variety of architectural patterns including rosette‐like microfollicular, solid, and morular. In addition, the background contains a minor population of atypical mesenchymal cells. The cytologic differential diagnosis of thyroblastoma includes primary thyroid neoplasms such as adenomatous nodule, follicular adenoma, follicular carcinoma, and poorly differentiated thyroid carcinoma as well as metastatic carcinoma.

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DICER1 Syndrome

Foulkes

Kock

Priest

2021

The Hereditary Basis of Childhood Cancer

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Successful Management of a Patient with Malignant Thyroid Teratoma

Abstract: To the authors' knowledge, DICER1 mutations have not been previously reported in teratomas but have been described in PNETs, suggesting a role in the malignant transformation of this case.

Cited by 20 publications

References 16 publications

Malignant teratoma of the thyroid: A difficult diagnosis by fine‐needle aspiration

Malignant teratoma of the thyroid: A difficult diagnosis by fine‐needle aspiration

Thyroblastoma: A DICER1‐associated embryonal neoplasm and fine needle aspiration diagnostic criteria

DICER1 Syndrome

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