Tall Cell Variant: An Aggressive Form of Papillary Thyroid Carcinoma

Abstract

Twenty-four cases of the tall cell variant (TCV), a subset of papillary thyroid carcinoma, were identified in a group of 624 patients with thyroid cancer. All pathology specimens were reviewed, and each patient's carcinoma was categorized according to characteristics on presentation, local recurrence, distant metastases, follow-up, and tumor-related mortality. The TCV group was compared with a historical control group (Mazzaferri and Jhiang: 1355 patients). The TCV group had a statistically higher percentage of stage 3 and 4 carcinoma, extrathyroidal invasion, and tumor size less than 1.5 cm than the control group. There was no statistical relationship between age greater than 50 years and stage in the TCV group. No relationship could be found between TCV histology and recurrence or mortality. These findings, combined with those of studies that link stage on presentation to poor outcomes, have led to our conclusion that TCV is an aggressive malignancy warranting appropriate treatment and close follow-up.

Prognostic Outcomes of Tall Cell Variant Papillary Thyroid Cancer: A Meta-Analysis

“…Mean tumor size was comparable to the tumor size in UV papillary thyroid cancer. Reviewing the data from [3, 8–10], the TCV patients had a higher rate of extrathyroidal extension (cumulative average of 60.33% patients) and higher rate of distant metastases at diagnosis (cumulative average of 15%). In addition, the cumulative average of lymph node metastases in TCV cases is 58.12% versus 34.5% in UV cases.…”

“…The published incidence of TCV is between 3.8% and 10.4% [1, 4–10]. Unlike the usually good prognosis of usual variant papillary thyroid cancer (UV), TCV histology is generally reported as an independently poor prognostic factor [1, 3, 5, 6, 8, 9]. …”

Tall cell variant of papillary thyroid carcinoma: current evidence on clinicopathologic features and molecular biology

“…The incidence of TCV varies from 1.3% to 13% of all PTC in literature [3, 18, 21, 24]. The variation in reported prevalence was mainly due to the various diagnostic criteria, difficulty in distinguishing TCV from other variants, and less attention paid to this entity at routine pathological examination.…”

“…However, it has been debated that whether the worse prognosis associated with TCV is attributable to various adverse clinico-pathological parameters or histological type alone. Some studies [7, 18, 41] have shown that TCV histology was not an independent risk factor for thyroid cancer recurrence and death postoperatively, and the most relevant factors being age, tumor size, ex­trathyroidal extension, and TNM stage in multivariate analysis.…”

Anaplastic Spindle Cell Squamous Carcinoma Arising from Tall Cell Variant Papillary Carcinoma of the Thyroid Gland: A Case Report and Review of the Literature

“…TCV PTC is an aggressive tumour characterised by its tall columnar shape, with a height : width ratio of 2-3 : 1 and abundant eosinophilic or oxyphilic cytoplasm [1, 2, 6, 7]. Although a rare occurrence, TCV PTC may transform into anaplastic SCSC.…”