Hürthle Cells Adenoma of the Thyroid with Post-surgical Implants in the Neck: Clinical, Morphological, and Molecular Analysis of Three Cases.

Détails

ID Serval
serval:BIB_52EAED0B49A2
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Hürthle Cells Adenoma of the Thyroid with Post-surgical Implants in the Neck: Clinical, Morphological, and Molecular Analysis of Three Cases.
Périodique
Endocrine pathology
Auteur(s)
Bongiovanni M., Uccella S., Giovanella L., Molinari F., Frattini M., Dionigi G., Piantanida E., Nobile A., Sessa F., La Rosa S.
ISSN
1559-0097 (Electronic)
ISSN-L
1046-3976
Statut éditorial
Publié
Date de publication
12/2016
Peer-reviewed
Oui
Volume
27
Numéro
4
Pages
338-345
Langue
anglais
Notes
Publication types: Case Reports ; Journal Article
Publication Status: ppublish
Résumé
Thyroid implants in the soft tissue of the neck are very rare findings of traumatic, iatrogenic, or neoplastic origins. We describe the clinico-pathological and molecular analysis of three cases with an initial diagnosis of follicular adenoma, Hürthle cell variant (FA-HCT), which developed cervical thyroid implants at 60, 59, and 36 months after thyroid surgery, followed by further neck recurrences, and, eventually, by distant metastases. A systematic review of all histopathological samples of both the primary lesions and the neck implants was performed. Molecular study included the analysis of pan-RAS and BRAF mutations and RET/PTC1, RET/PTC3, and PAX8/PPARγ rearrangements. The review of the original slides and of additional re-cuts of each block of the thyroid lesions did not show any sign of capsular and/or vascular invasion; thus, the original diagnoses of FA-HCT were confirmed. When sampling adequacy was considered, it turned out that the capsule was completely evaluable in case #3, whereas 85 % was evaluable for case #1 and less than 50 % for case #2. We cannot exclude that cases #1 and #2 were carcinomas that had not been completely sampled. The first occurring neck implants showed neither histological signs of malignancy nor the presence of lymphoid tissue. However, further neck recurrences had different histological aspects, with a clear infiltrative growth. Moreover, a mesenchymal reaction forming a sort of capsule was observed around oncocytic cells along with signs of vascular invasion. Molecular analysis revealed no alterations in the genes and rearrangements studied. Oncocytic thyroid implants in the neck soft tissue should be regarded as metastasis, even in the absence of clear-cut signs of malignancy and in the case of a bona fide diagnosis of Hürthle cells adenoma of the thyroid.

Mots-clé
Adenoma, Oxyphilic/pathology, Adult, Female, Humans, Male, Middle Aged, Neck/pathology, Neoplasm Metastasis/pathology, Neoplasm Recurrence, Local/pathology, Thyroid Neoplasms/pathology
Pubmed
Web of science
Création de la notice
06/09/2016 12:53
Dernière modification de la notice
20/08/2019 14:08
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