Primary Squamous Cell Carcinoma of the Thyroid: Report of Three Cases

ArticleinEndocrine Journal 55(2):359-64 · June 2008with15 Reads
DOI: 10.1507/endocrj.K07E-102 · Source: PubMed
Abstract
We report three cases of squamous cell carcinoma of the thyroid, which is an unusual malignant tumor that needs to be distinguished from other thyroid pathologies due to its aggressive behaviour. Three men, with an average of 63 years old, presented with progressive enlargement in the neck, hoarse voice or weight loss. Physical and radiological examinations revealed clues where malignancy was suspected and surgical resections were performed. Histopathological examination of the specimens was diagnosed as squamous cell carcinoma. Proper workup excluded the possibility of any primary site of SCC other than the thyroid. All patients died within 5 months. Adjuvant therapy evaluation is still inconclusive. Complete surgical resection still remains the primary choice for cure. We believe that radical resection with clear surgical margins followed by adjuvant chemo-radiation therapy is a curative strategy for achieving any chance of long-term survival.
    • "There are several theories to account for the etiology of primary SCC of the thyroid. The embryonic nest theory suggests that squamous cells are derived from embryonic remnants such as the thyroglossal duct and the metaplasia theory posits that environmental stimuli such as inflammation (Hashimoto's thyroiditis) can lead to squamous metaplasia [1]. In our patient, however, there were no histologic findings suggestive of an embryonic remnant or squamous metaplasia. "
    Article · Jan 2015 · Head & Neck Oncology
    • "The best treatment for SCC of the thyroid is early diagnosis followed by aggressive surgery, in order to prevent suffocation by bleeding or obstruction [12]. Adjuvant treatment combining chemotherapy with radiotherapy, in an attempt to reduce the risk of locoregional recurrence, has shown poor efficacy. "
    [Show abstract] [Hide abstract] 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
    • "Treatment with surgery, radiation therapy and chemotherapy alone has been found ineffective in previously published similar case reports, as majority of these patients present as locally advanced cases not amenable for curative resectionTable 1 . The better survival rates have been achieved with aggressive combination therapy (surgery followed by adjuvant radiation therapy (50-60 Gy) with or without chemotherapy or induction chemotherapy followed by surgery)111213141516. "
    [Show abstract] [Hide abstract] ABSTRACT: Thyroid gland lacks squamous epithelium (except in some rare situations like embroyonic remnants or in inflammatory processes); for that reason the primary squamous cell carcinoma (SCC) of thyroid is extremely rare entity, seen only in less than 1% of all thyroid malignancies and is considered almost fatal. So, far, only few case reports have been published in literature. Herein we present a 54 years old Saudi female with 3 months history of progressive neck swelling and hoarse voice, who was referred to us by her primary care physician as suspected case of anaplastic carcinoma of thyroid for radical external beam radiation therapy (EBRT). Fine Needle aspiration cytology (FNAC) revealed squamous cell carcinoma. Computed tomography (CT) neck showed 10 × 10 cm mass in left lobe of thyroid invading trachea and skin. Extensive staging work up ruled out the possibility of any primary site of SCC other than thyroid gland. Tumor was found unresectable and was referred to radiation oncology. She received palliative EBRT 30 Gy in 10 fractions. After completion of EBRT, there was progression of disease and patient died 3 months after completion of EBRT by airway compromise. Primary SCC of thyroid is rare and aggressive entity. FNAC is reliable and effective tool for immediate diagnosis. Surgery is a curative option, but it is not always possible as most of cases present as locally advanced with adjacent organs involvement. EBRT alone was found ineffective. Aggressive combined modality (debulking surgery, radiation and chemotherapy) shall be considered for such cases.
    Full-text · Article · Mar 2012
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