Fine‐needle aspiration biopsy of primary osteosarcoma of the thyroid: Report of a case and review of the literature

Department of Pathology, Columbia University Medical Center, New York, New York 10032, USA.
Diagnostic Cytopathology (Impact Factor: 1.52). 08/2008; 36(8):589-94. DOI: 10.1002/dc.20840
Source: PubMed

ABSTRACT Primary osteosarcoma of the thyroid is an extremely rare tumor, with only 27 well-documented cases reported in the literature, including only one in the cytology literature. We describe here an additional case with fine-needle aspiration biopsy findings. A 60-year-old woman presented with a 1-month history of progressive midline neck swelling. CT and ultrasound demonstrated a large thyroid mass with tracheal compression. Fine-needle aspiration biopsies were performed and showed pleomorphic spindle and epithelioid neoplastic cells, multinucleated giant cells, and scant metachromatic extracellular matrix material. Cell block sections contained minute tissue fragments with neoplastic spindle cells. Immunohistochemical stains showed the tumor cells to be positive for vimentin and negative for cytokeratins, TTF-1, calcitonin, synatophysin, chromogranin, and S-100 protein, suggesting a sarcoma; however, the differential diagnosis also included anaplastic thyroid carcinoma and medullary thyroid carcinoma. Tissue biopsy revealed a high-grade spindle cell neoplasm with osteoid production, consistent with osteosarcoma of the thyroid. The patient developed a large pulmonary embolus and superior vena cava syndrome and no further surgical intervention was performed. She died 5 weeks after the initial diagnosis. Upon retrospective review, the cytologic features resemble osteosarcoma in other areas. Although cytologic features on fine-needle aspiration biopsy may suggest a diagnosis of this rare entity, definitive diagnosis should be deferred to histologic examination.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: A rare localization of primary osteosarcoma is presented. A woman aged 76 years was operated on for rapid growth of thyroid right lobe tumour. Histopathology showed anaplastic cancer with numerous foci of osseous metaplasia, negative with thyroglobulin, calcitonin, synaptophysin and chromogranin. A high proliferative activity of the tumour was observed (MIB-1 reaction) in the form of a positive reaction in approx. 40% of the tumour cell nuclei. The tumour stage was evaluated as pT4aNxMx according to the TNM scale. The reconsultation revealed negative staining with cytokeratin, and positive with vimentin, thereby confirming the mesenchymal origin of the tumour, with the final diagnosis being primary thyroid osteosarcoma. Taking into consideration the histopathological diagnosis, the extremely low radiation sensitivity of the tumour, the patient's age, the radical surgical treatment and persisting respiratory failure, radiotherapy was rejected in favour of further follow-up. The patient remains under oncological and endocrinological care.
    Contemporary Oncology / Wspólczesna Onkologia 03/2013; 17(1):97-99. DOI:10.5114/wo.2013.33783 · 0.22 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Thyroid tumors are one of the most common tumors of the endocrine system encountered in surgical pathology practice. They can arise from the follicular lining epithelial cells that produce the thyroid hormone or the C cells that secrete calcitonin. In this chapter we discuss non-C cell tumors of the thyroid. In this group of tumors papillary carcinoma is the most common malignancy and the conventional type of tumor can be easily diagnosed based on classical cytomorphologic features. However, variants of papillary carcinoma exist, the understanding of which is crucial for accurate diagnoses. The follicular patterned tumors may sometimes pose diagnostic challenge and approach to these thyroid lesions is suggested in this section along with ancillary studies that may help in the diagnosis of these tumors. Finally, thyroid cancer progression from differentiated carcinoma to poorly differentiated and anaplastic carcinoma is well known and is also presented along with clinical and pathological correlations. KeywordsThyroid carcinoma–Follicular adenoma–Follicular variant of papillary carcinoma–Follicular-patterned lesions–Follicular carcinoma–Papillary thyroid carcinoma–Insular carcinoma–Anaplastic carcinoma–Oncocytic carcinoma–Oncocytic adenoma–Hyalanizing trabecular tumor–Papillary thyroid carcinoma variants
    03/2010: pages 41-81;
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Anaplastic thyroid carcinoma (ATC) is the most aggressive form of thyroid cancer. It shows a wide spectrum of morphological presentations and the diagnosis could be challenging due to its high degree of dedifferentiation. Molecular and genetic features of ATC are widely heterogeneous as well and many efforts have been made to find a common profile in order to clarify its cancerogenetic process. A comprehensive review of the current literature is here performed, focusing on histopathological and genetic features.
    International Journal of Endocrinology 08/2014; 2014:790834. DOI:10.1155/2014/790834 · 1.52 Impact Factor