The mandibular metastatic spread of carcinoma from the thyroid gland is exceedingly rare. Follicular thyroid carcinoma is the second most common type of thyroid carcinoma，accounting for approximately 10% to 15% of all thyroid cancers. The prognosis of FTC is relatively satisfactory. Due to its rich blood transport, it is easy to metastasize hematological, with the main sites of metastasis are bone and lung. However，mandibular metastasis of thyroid follicular carcinoma is rare. We report a case of thyroid follicular carcinoma that metastasized to the ascending ramus of the mandible 21 years after surgery.The operation was successfully completed, and there was no recurrence during postoperative follow-up. Due to the absence of obvious clinical symptoms in the patient, the diagnosis and treatment were challenging. We have provided detailed radiographic and pathological images to facilitate understanding and discussion of the disease.
Humans ; Adenocarcinoma, Follicular/pathology* ; Thyroid Neoplasms/surgery* ; Prognosis ; Mandible

Humans ; Thyroid Neoplasms/pathology* ; Carcinoma, Papillary/pathology* ; World Health Organization ; Adenocarcinoma, Follicular/pathology*

Angiosarcoma of the thyroid has long been a controversial entity, and it is histologically defined as cleft-like anastosmosing spaces lined by large, atypical cells of endothelial lineage. However, clear-cut separation between the angiosarcoma and anaplastic carcinoma of the thyroid is difficult because they yield nearly the same clinical prognosis and overlapping histologic findings. We report a case of thyroid neoplasm composed of minimally invasive well differentiated follicular carcinoma and angiosarcoma with intervening transitional area. Immunohistochemically, the angiosarcomatous portion showed focal immunoreactivity for endothelial markers such as CD31, CD34, Ulex europaeus 1 lectin, factor VIII-related antigen, and immunonegativity for epithelial markers including pancytokeratin, epithelial membrane antigen and thyroglobulin, whereas the reverse was demonstrated in the minimally invasive follicular carcinomatous portion. The follicular carcinoma portion was positive for thyroid transcription factor-1 (TTF-1). Each component showed ultrastructural findings of epithelial and endothelial differentiation, respectively. The present case was unique in that angiosarcoma of the thyroid was confirmed by immunohistochemistry and electron microscopy, as well as light microscopy, and also coexisted with a minimally invasive well differentiated follicular carcinoma in the same mass. This combination has never been described in the literature. Although restricted to a single case, the present case further supports that angiosarcoma is a true existent entity rather than a variant of anaplastic carcinoma.
Adenocarcinoma, Follicular/*pathology ; Comorbidity ; Diagnosis, Differential ; Hemangiosarcoma/*pathology ; Human ; Male ; Microscopy, Electron ; Middle Aged ; Thyroid Neoplasms/*pathology ; Tumor Markers, Biological

Adenocarcinoma, Follicular ; pathology ; physiopathology ; Female ; Humans ; Kidney Diseases ; pathology ; physiopathology ; Kidney Neoplasms ; physiopathology ; Thyroid Neoplasms ; pathology ; physiopathology ; Young Adult

Adenocarcinoma, Follicular ; classification ; diagnosis ; pathology ; Carcinoma, Papillary ; diagnosis ; pathology ; surgery ; Humans ; Lymphatic Metastasis ; Thyroid Neoplasms ; diagnosis ; pathology ; surgery

OBJECTIVE: To discuss the meanings of Oct-4's expression in thyroid adenoma, thyroid papillary carcinoma, thyroid follicular carcinoma, and medullary thyroid carcinoma. METHOD: We examined the expression of Oct-4 in 15 thyroid adenoma, 30 thyroid papillary carcinomas, 2 thyroid follicular carcinomas, and 3 medullary thyroid carcinomas using immunofluorescence. RESULT: Oct-4 expression was observed in all the thyroid-related diseases mentioned above. In thyroid papillary carcinomas, the expression of Oct-4 were higher than that in thyroid adenoma, and had no obvious relationship with the patients age, sex, the size and location of tumor and tumor metastasis. CONCLUSION The formation of the thyroid carcinomas may be concerned with the stem cells in thyroid. There are more stem cells in medullary thyroid carcinomas and follicular carcinomas.
Adenocarcinoma, Follicular ; metabolism ; pathology ; Carcinoma, Neuroendocrine ; Carcinoma, Papillary ; metabolism ; pathology ; Humans ; Octamer Transcription Factor-3 ; metabolism ; Thyroid Neoplasms ; metabolism ; pathology

BACKGROUND: Malignant follicular lesion is not differentiated from benign lesions cytologically. The objective of this study was to assess the rate and the risk of malignancy in thyroid nodules which were cytologically diagnosed as follicular neoplasm by fine-needle aspiration (FNA) cytology. METHODS: All the patients who had undergone surgery with cytological diagnosis of follicular neoplasm from January 1996 through December 2001 in Asan Medical Center were studied retrospectively. Patients' and nodule characteristics were analyzed for factors associated with the presence of cancer. Two hundred and fifteen patients (196 females, 19 males) were included and their mean age was 39.4 years (range: 12~76). RESULTS: About half of the patients (102 out of 215, 47.4%) had malignancy with 29 papillary carcinomas, 57 follicular carcinomas, 15 H rthle cell carcinomas and 1 medullary carcinoma. Previously suggested factors associated with risk for malignancy, such as male gender, large tumor size (> 4 cm) or age of patients (> 45 years), were not associated with increased risk. Diagnosis of H rthle cell neoplasia on FNA was also not associated with increased risk. Only the extremes in age of the patients (below 20 or above 60 years) were associated with increased risk for malignancy. CONCLUSION: In our findings, prevalence of carcinoma in thyroid nodule patients with cytological diagnosis of follicular neoplasm was much higher than those reported. Clinical characteristics, such as male gender, age and nodule size, are not useful predictors for the presence of malignancy. Thyroid nodules with cytological diagnosis of follicular neoplasm warrant immediate surgery.
Adenocarcinoma, Follicular/pathology ; Adenoma, Oxyphilic/pathology ; Adolescent ; Adult ; Age Factors ; Aged ; Biopsy, Needle ; Carcinoma, Medullary/pathology ; Carcinoma, Papillary, Follicular/pathology ; Child ; Female ; Human ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Thyroid Neoplasms/*pathology ; Thyroid Nodule/*pathology ; Thyroidectomy ; Thyroiditis, Autoimmune/pathology

Adenocarcinoma, Follicular ; diagnosis ; pathology ; Adenoma ; diagnosis ; pathology ; Carcinoma, Papillary ; diagnosis ; pathology ; Carcinoma, Papillary, Follicular ; diagnosis ; pathology ; Cell Nucleus ; pathology ; Diagnosis, Differential ; Humans ; Neoplasm Invasiveness ; Thyroid Gland ; pathology ; Thyroid Neoplasms ; diagnosis ; pathology ; Thyroid Nodule ; diagnosis ; Thyroiditis ; diagnosis

We describe herein histologic, immunohistochemical, and molecular findings and clinical manifestations of a rare case of an extremely well differentiated papillary thyroid carcinoma (EWD-PTC). Similarly, it is also difficult to diagnose follicular variant papillary thyroid carcinoma (FVPTC), whose diagnosis is still met with controversy. A recently reported entity of well-differentiated tumor of uncertain malignant potential (WDT-UMP) is added to the diagnostic spectrum harboring EWD-PTC and FVPTC. We report this case, because EWD-PTC is different from FVPTC in its papillary architecture, and also from WDT-UMP in its recurrence and metastatic pattern. These morphologically deceptive entities harbored diagnostic difficulties in the past because the diagnosis depended solely on histology. However, they are now diagnosed with more certainty by virtue of immunohistochemical and molecular studies. We experienced a case of EWD-PTC, which had been diagnosed as adenomatous hyperplasia 20 years ago and manifested recurrence with lymph node (LN) metastasis 7 years later. After another 7 years of follow-up, a new thyroid lesion had developed, diagnosed as FVPTC, with LN metastasis of EWD-PTC. One year later, the patient developed metastatic FVPTC in the skull. Immunohistochemically, the EWD-PTC was focally positive for CK19, negative for galectin-3, and focally negative for CD56. Molecular studies revealed BRAF-positivity and K-RAS negativity. The FVPTC in the left thyroid showed both BRAF and K-RAS negativity. In conclusion, EWD-PTC and FVPTC share similar histologic features, but they are different tumors with different molecular biologic and clinical manifestations. A large cohort of EWD-PTC should be included in further study.
Adenocarcinoma, Follicular/pathology/secondary ; Adult ; Carcinoma, Papillary, Follicular/pathology/*secondary ; Female ; Galectin 3/analysis ; Humans ; Hyperplasia/pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Recurrence, Local/pathology ; Skull Neoplasms/*secondary ; Thyroid Neoplasms/*pathology

Incidence of thyroid carcinoma has increased dramatically; however, simultaneous occurrence of different tumors in a single thyroid gland is rare and the embryologic or molecular explanations for such cases lack a solid basis. We report on a 67-year-old woman who underwent surgery for cytologically undetermined nodules in the bilateral thyroid glands. Postoperative pathology findings indicated synchronous occurrence of discrete papillary, follicular, and medullary thyroid carcinoma. She has remained disease-free after postoperative radioactive iodine therapy (130 mCi). This is the fifth report on the synchronous occurrence of different tumors in a single thyroid gland worldwide, and the first ever in Asia.
Adenocarcinoma, Follicular ; Aged ; Asia ; Carcinoma, Medullary* ; Female ; Humans ; Incidence ; Iodine ; Neoplasms, Multiple Primary ; Pathology ; Thyroid Gland* ; Thyroid Neoplasms