Primary Synovial Sarcoma of the Thyroid: Challenges in Cytologic Diagnosis and Review of the Literature
| Autor: | Gizem Issin, Ibrahim Ramzy, Suna Erkiliç, Evren Erkul, Dilaver Demirel |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Pathology
medicine.medical_specialty Histology Mitotic index medicine.diagnostic_test business.industry Thyroid General Medicine Gene rearrangement Pathology and Forensic Medicine Modified Radical Neck Dissection medicine.anatomical_structure Fine-needle aspiration Primary Synovial Sarcoma Cytopathology medicine Differential diagnosis business |
| Zdroj: | Acta Cytologica. 64:498-506 |
| ISSN: | 1938-2650 0001-5547 |
| DOI: | 10.1159/000507312 |
| Popis: | Background: Primary synovial sarcoma (SS) of the thyroid (PSST) is extremely rare. Its differential diagnosis from other neoplasms is essential since it has different management protocols and prognosis. Case: A 26-year-old man with a 4.5-cm solid lobulated mass was seen at an outside hospital. Fine needle aspiration (FNA) was interpreted as a papillary carcinoma, and a total thyroidectomy was performed. The final histologic diagnosis was spindle epithelial tumor with thymus-like differentiation (SETTLE). No metastases were detected at that time, and the patient received radioactive iodine treatment. Two years post-surgery, he was seen at our hospital with a local recurrence, and FNA was considered as consistent with SETTLE. The mass was resected, and a left modified radical neck dissection was performed. The tumor revealed necrosis and a high mitotic index. Following histologic, immunohistochemical, and molecular studies, the tumor was classified as a PSST. The patient received chemotherapy and targeted immunotherapy, but he died 41 months after the initial presentation. Conclusion: The main diagnostic pitfall of PSST is SETTLE. The presence of mitotic figures and basal lamina material, negative staining for smooth muscle actin, and positive staining for transducer-like enhancer of split 1 antibody favor SS over SETTLE. SYT gene rearrangement is essential to establish the definitive diagnosis of PSST. |
| Databáze: | OpenAIRE |
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