Collision tumor of a thyroid papillary and follicular carcinoma: A case report

Author:

Kawasaki Kanako1,Kai Keita2,Tanaka Nariyuki1,Kido Shinichi1,Ibi Arisa2,Minesaki Akimichi1,Yamauchi Moriyasu1,Kuratomi Yuichiro1,Aishima Shinichi1,Nakashima Masahiro3,Ito Masahiro4

Affiliation:

1. Saga University Faculty of Medicine

2. Saga University Hospital

3. Nagasaki University

4. National Hospital Organization Nagasaki Medical Center

Abstract

Abstract Background: Papillary thyroid carcinoma (PTC) and follicular thyroid carcinoma (FTC) are common differentiated thyroid cancers, but the detection of a collision tumor is an extremely rare event. Case Presentation: The patient was a 69-year-old Japanese female with multiple cervical lymph node swellings and a thyroid tumor. Preoperative fine needle aspiration cytology of the enlarged lymph node revealed a cytological diagnosis of papillary thyroid carcinoma (PTC). A total thyroidectomy, right cervical dissection and paratracheal dissection were performed. Histopathological immunohistochemistry (IHC) analyses of resected specimens revealed a collision tumor of PTC and FTC. Multiple metastases of papillary carcinoma were found in the dissected lymph nodes. In the PTC lesion, IHC for BRAF (V600E) was positive but negative for the FTC lesion. Genetic analyses further revealed a TERT prompter C228T mutation in PTC and a NRAS codon 61 mutation in FTC. The patient died of recurrent cancer 8 months after surgery. Conclusions: A case of a collision tumor of PTC and FTC is very rare, and even fewer cases have been subjected to genetic scrutiny. The present case was successfully diagnosed by pathological examination using IHC and genetic analyses. The TERT promoter mutation in the PTC lesion was consistent with the aggressive behavior of the cancer.

Publisher

Research Square Platform LLC

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4. Synchronous primary hyperparathyroidism, follicular thyroid carcinoma, and papillary thyroid carcinoma;Dai DJ;Chin Med J,2019

5. Adrenal metastasis as the initial diagnosis of synchronous papillary and follicular thyroid cancer;He X;Clin Diabetes Endocrinol,2020

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