Squamous cell carcinoma of the thyroid gland: Primary or secondary disease?

Department of Otolaryngology and Head and Neck Surgery, Southern General Hospital, Greater Glasgow and Clyde NHS Trust, Glasgow, UK.
The Journal of Laryngology & Otology (Impact Factor: 0.67). 10/2010; 125(1):3-9. DOI: 10.1017/S0022215110002070
Source: PubMed


To review the aetiopathogenesis, clinical characteristics, immunohistochemical profile, prognosis and treatment options for primary thyroid squamous cell carcinoma, and to compare it with squamous cell carcinoma metastatic to the thyroid, thus providing the reader with a framework for differentiating primary and secondary disease.
Review of English language literature from the past 25 years.
A search of the Medline, Embase and Cochrane databases (April 1984 to April 2009) was undertaken to enable a comprehensive review.
After applying strict criteria for the diagnosis of primary thyroid squamous cell carcinoma, 28 articles were identified reporting 84 cases. When reviewing secondary thyroid squamous cell carcinoma, we only analysed cases of squamous cell carcinoma metastatic to the thyroid gland, and found 28 articles reporting 78 cases.
It is possible to differentiate between primary and secondary thyroid squamous cell carcinoma, on the basis of combined evidence from clinical examination and endoscopic, pathological and radiological evaluation. Such differentiation is important, as the prognosis for primary squamous cell carcinoma is uniformly poor irrespective of treatment, and the most suitable option may be supportive therapy. Treatment for secondary squamous cell carcinoma of the thyroid varies with the site and extent of spread of the primary tumour.

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    • "In the last few years because of few case reports, metaplastic theory is gaining recognition and some authors have observed PSCC of thyroid arising in the setting of lymphocytic thyroiditis, suggesting that squamous metaplasia of follicular cells is due to continuous stimulation [5]. Because of its rarity, the role and outcome of chemoradiation in management of PSCC of thyroid have not been properly studied, though many studies suggest that it is poorly responsive to either chemotherapy or radiotherapy [6] [10]. So the best treatment is early diagnosis and aggressive surgery with goal of achieving R0 resection, though it may be rarely possible. "
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    ABSTRACT: Primary squamous cell carcinoma (PSCC) of thyroid is an extremely rare malignancy of thyroid. Herewith, we describe a case report of female patient who presented with neck swelling; FNAC misdiagnosed it as papillary carcinoma of thyroid but, after resection, biopsy revealed it to be a case of squamous cell carcinoma of thyroid. After extensive investigations no possible primary focus of squamous cell carcinoma was found elsewhere, so diagnosis of primary squamous cell carcinoma of thyroid was made. Patient underwent chemoradiation but still patient succumbed to death within a year.
    Full-text · Article · Jul 2015
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    • "Exclusion of primary lesions in other organs is performed to differentiate between primary and secondary SCC [9]. "
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    ABSTRACT: A case of primary squamous-cell carcinoma (SCC) of the thyroid which had been initially diagnosed as an anaplastic carcinoma (ATC) is described: female, 73 years old, with a fast-growing cervical nodule on the left side and hoarseness for 3 months. Ultrasonography showed a 4.5 cm solid nodule. FNA was compatible with poorly differentiated carcinoma with immunoreactivity for AE1/AE3, EMA.Thyroidectomy was performed. Histopathological examination showed a nonencapsulated tumor. Immunohistochemistry disclosed positivity for AE1/AE3, p53,p63, and Ki67. The diagnosis was ATC. A second opinion reported tumor consisting of squamous cells, with intense inflammatory infiltrate both in tumor and in the adjacent thyroid, with final diagnosis of SCC, associated with Hashimoto thyroiditis. No other primary focus of SCC was found. Patient has shown a 48- month survival period. Clinically, primary SCCs of the thyroid and ATCs are similar. The distinction is often difficult particularly when based on the cytological analysis of FNA material.
    Full-text · Article · Sep 2014
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    • "While an immunocompromised state can accelerate neoplastic growth, this patient had a complete immune workup, and no deficiencies were detected. Presenting symptoms can include sudden onset of an enlarging mass, dysphagia, hoarseness, and pain, which were noted in the case presented [4,7]. Radiographically, PSCC often presents with advanced infiltration and effacement of neighbouring structures, which was noted in our case, given the invasion of the esophagus, displacement of the trachea and proximity to neck vasculature. "
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    ABSTRACT: Background Lacking any squamous epithelium, thyroid gland with primary squamous cell carcinoma (PSCC) proves to be an etiopathophysiological quandary. Two major theories do exist, though few cases have been documented to support either. We present a case that supports the “metaplasia” theory, which serves to enhance our understanding of a disease that carries with it a very poor prognosis. Case presentation We present a case of an extremely advanced, primary squamous cell carcinoma of the thyroid with distant metastases in a thirty-six year-old male. Dying of airway compromise seventeen days following his admission, this is the shortest median survival of all documented cases. Conclusion In addition to being the most abbreviated time period between presentation and death of all documented thyroid primary squamous cell carcinomas, we share the fifth case of thyroid PSCC in the setting of lymphocytic thyroiditis. This case should build awareness of the aggressivity of the disease and the lack of established diagnostic criteria.
    Full-text · Article · Jun 2014 · Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale
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