Primary Mucinous Carcinoma of the Thyroid: A Case Report, Literature Review, and Immunohistochemistry Summary.

HCA healthcare journal of medicine Pub Date : 2024-03-29 eCollection Date: 2024-01-01 DOI:10.36518/2689-0216.1570
Martin T Halicek, Caleb Scott, Terence Zimmermann, Brian Watson
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Abstract

Introduction: Primary mucinous carcinoma of the thyroid is an exceedingly rare malignancy that is histologically similar to mucinous carcinoma of other sites. Accurate diagnosis is a challenging yet crucial component of clinical management for both patients and our understanding of this rare disease.

Case presentation: We report the case of a 69-year-old male patient with primary mucinous carcinoma of the thyroid. Microscopic examination of a biopsy specimen showed fibrous tissue, which was extensively and irregularly infiltrated by a cytologically malignant epithelial neoplasm showing glandular differentiation with mucin production. Immunohistochemistry demonstrated that tumor cells were positive for TTF1, thyroglobulin, CK7, and PAX8. Co-expression of TTF1 and PAX8 is most commonly seen in thyroid tumors. These findings support our diagnosis of mucinous carcinoma of thyroid origin, which is rare and highly aggressive.

Conclusion: In this report, we present the only documented case of primary mucinous carcinoma of the thyroid reported in the United States in the last decade. The diagnosis of primary mucinous carcinoma of the thyroid can be challenging. Therefore, we discuss and detail the clinicopathologic tumor profile and provide more current, detailed histological criteria to assist in the diagnosis of this rare disease.

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甲状腺原发性黏液癌:病例报告、文献综述和免疫组化总结。
导言:甲状腺原发性黏液癌是一种极为罕见的恶性肿瘤,在组织学上与其他部位的黏液癌相似。准确诊断对患者的临床治疗和我们对这种罕见疾病的认识都具有挑战性,但也是至关重要的组成部分:我们报告了一名69岁男性甲状腺原发性黏液癌患者的病例。活检标本的显微镜检查显示,纤维组织被细胞学恶性上皮肿瘤广泛、不规则地浸润,显示出腺体分化并产生粘蛋白。免疫组化显示,肿瘤细胞的 TTF1、甲状腺球蛋白、CK7 和 PAX8 均呈阳性。TTF1和PAX8的共表达在甲状腺肿瘤中最为常见。这些发现支持了我们对甲状腺粘液腺癌的诊断,这种癌症非常罕见,且具有高度侵袭性:在本报告中,我们介绍了近十年来美国报告的唯一一例原发性甲状腺粘液癌病例。原发性甲状腺粘液癌的诊断具有挑战性。因此,我们讨论并详细介绍了肿瘤的临床病理特征,并提供了更多最新、更详细的组织学标准,以帮助诊断这种罕见疾病。
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