Squamous cell carcinoma arising in a papillary carcinoma of the tyroid: A case report

Service d'Immuno-Histo-Cytologie, Institut salah Azaiz, Tunis.
La Tunisie médicale 04/2007; 85(3):251-3.
Source: PubMed


primary squamous cell carcinoma (scc) of the thyroid is a rare malignant tumor that needs to be distinguished from other neoplasms. Cases of papillary carcinoma merging in association with squamous cell carcinoma are extremely rare.
the characteristics of such association will be studied herein through a review of literature.
we report a case of an 87-year-old patient presented with an enlarged right lobe of the thyroid. Thyroid scintigraphy revealed a cold nodule. Clinically, malignancy was suspected. Histopathologic diagnosis was a well-differentiated scc associated with areas of papillary carcinoma. Exhaustive clinical, endoscopic and radiological examinations did not reveal any primary site of scc or any contiguous spread from neighboring structures. Surgery was followed by radiotherapy, but the patient died 6 months later.
the coexistence of epidermoide and papillary carcinomas in the thyroid gland must be known because of its prognostic impact.

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    ABSTRACT: The Herrenschmidt tumor or primary squamous cell carcinoma of the thyroid is a rare tumor. It represents less than 1% of all thyroid cancers. It is characterized by its rapid and aggressive evolution like anaplastic carcinoma. Our work is a retrospective study of five cases of pure squamous cell carcinoma of the thyroid confirmed histologically. All patients were female, with an average age of 57; the reason for consultation was a goiter, characterized by its hard consistency. Cervical lymph nodes were palpated in one patient. The curative total thyroidectomy was possible only in two patients. The prognosis was generally poor with a survival of about a few months, especially in bad quality of life. Radical surgery when possible seems the only potential curative. However, late diagnosis and the aggressive evolution allow only palliative thyroidectomy, to avoid compression.
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    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.
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