Warthin-like Tumor of the Thyroid - A Rare Variant of Papillary Thyroid Cancer: Report of Two Cases

Abstract

Background. Warthin-like tumor of the thyroid (WALTT) is a very rare variant of papillary thyroid cancer.We want to draw attention to this rare condition by reporting two cases.Patient reports. Patient 1 was a 24 year-old woman presented with 14×12 mm solid nodule on the left lobe of the thyroid gland. Fine needle aspiration biopsy of the nodule was reported as suspicious for papillary thyroid carcinoma. Patient 2 was a 40 year-old woman who had multinodular thyroid gland with a 31×26 mm major nodule on the left lobe. On fine neddle aspiration, cytologic findings were consistent with papillary thyroid carcinoma. Both underwent total thyroidectomy and histological examination of the cases revealed Warthin-like tumor of the thyroid. Summary and conclusion. We report two patients with WALTT. This rare variant of papillary thyroid cancinoma has four main histologic criteria: papillary architecture, oxyphilic cytoplasmic changes, papillary nuclear features and dense lymphoid infiltrate. WALTT can be distinguished from other aggressive variants with these distinct histological features. Since variants show different clinical behaviour, classification of these might be helpful to predict patient prognosis.

Warthin-Like Papillary Thyroid Carcino Ma: Report of a New Case

“…However, there are no reports regarding data on long-term outcomes (22). In our case, follow-up period is inadequate to comment about the prognosis.…”

“…The distinctive feature is the lymphocytic infiltration of the stalks of the papillae as in our case (6,12,13,22). Vascular and capsular invasions are rare.…”

“…Although the prognosis of patients with WLPTC is similar to that of patients with conventional PTC (22), two patients in the English literature showed a poor prognosis due to anaplastic changes in the tumor (9,20). However, there are no reports regarding data on long-term outcomes (22).…”

“…Warthin-like papillary thyroid carcinoma (WLPTC) is an uncommon variant of thyroid PTC (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). This morphologic variant is characterized by a prominent lymphocytic infiltration in the stalks of the papillae and in the surrounding stroma with extensive oxyphilic change of epithelium, resembling Warthin tumor of the salivary gland (6,7).…”