Back
Hürthle Cells Adenoma of the Thyroid with Post-surgical Implants in the Neck: Clinical, Morphological, and Molecular Analysis of Three Cases.
Journal article

Hürthle Cells Adenoma of the Thyroid with Post-surgical Implants in the Neck: Clinical, Morphological, and Molecular Analysis of Three Cases.

  • Bongiovanni M Institute of Pathology, University Hospital, Rue du Bugnon 25, CH-1011, Lausanne, Switzerland. massimo.bongiovanni@chuv.ch.
  • Uccella S Department of Surgical and Morphological Sciences, University of Insubria, Via O. Rossi 9, 21100, Varese, Italy.
  • Giovanella L Department of Nuclear Medicine and Thyroid Centre, Oncology Institute of Southern Switzerland, Viale Officina 3, CH-6500, Bellinzona, Switzerland.
  • Molinari F Institute of Pathology, Via in Selva 24, CH-6600, Locarno, Switzerland.
  • Frattini M Institute of Pathology, Via in Selva 24, CH-6600, Locarno, Switzerland.
  • Dionigi G Department of Surgical and Morphological Sciences, University of Insubria, Via O. Rossi 9, 21100, Varese, Italy.
  • Piantanida E Division of Endocrinology, Department of Clinical Medicine, University of Insubria, Via O. Rossi 9, 21100, Varese, Italy.
  • Nobile A Institute of Pathology, University Hospital, Rue du Bugnon 25, CH-1011, Lausanne, Switzerland.
  • Sessa F Department of Surgical and Morphological Sciences, University of Insubria, Via O. Rossi 9, 21100, Varese, Italy.
  • La Rosa S Department of Pathology, Ospedale di Circolo, Viale Borri 57, 21100, Varese, Italy.
Show more…
  • 2016-04-25
Published in:
  • Endocrine pathology. - 2016
Follicular adenoma
Hürthle cells
Malignant transformation
Molecular analysis
Thyroid implants
Adenoma, Oxyphilic
Adult
Female
Humans
Male
Middle Aged
Neck
Neoplasm Metastasis
Neoplasm Recurrence, Local
Thyroid Neoplasms
English Thyroid implants in the soft tissue of the neck are very rare findings of traumatic, iatrogenic, or neoplastic origins. We describe the clinico-pathological and molecular analysis of three cases with an initial diagnosis of follicular adenoma, Hürthle cell variant (FA-HCT), which developed cervical thyroid implants at 60, 59, and 36 months after thyroid surgery, followed by further neck recurrences, and, eventually, by distant metastases. A systematic review of all histopathological samples of both the primary lesions and the neck implants was performed. Molecular study included the analysis of pan-RAS and BRAF mutations and RET/PTC1, RET/PTC3, and PAX8/PPARγ rearrangements. The review of the original slides and of additional re-cuts of each block of the thyroid lesions did not show any sign of capsular and/or vascular invasion; thus, the original diagnoses of FA-HCT were confirmed. When sampling adequacy was considered, it turned out that the capsule was completely evaluable in case #3, whereas 85 % was evaluable for case #1 and less than 50 % for case #2. We cannot exclude that cases #1 and #2 were carcinomas that had not been completely sampled. The first occurring neck implants showed neither histological signs of malignancy nor the presence of lymphoid tissue. However, further neck recurrences had different histological aspects, with a clear infiltrative growth. Moreover, a mesenchymal reaction forming a sort of capsule was observed around oncocytic cells along with signs of vascular invasion. Molecular analysis revealed no alterations in the genes and rearrangements studied. Oncocytic thyroid implants in the neck soft tissue should be regarded as metastasis, even in the absence of clear-cut signs of malignancy and in the case of a bona fide diagnosis of Hürthle cells adenoma of the thyroid.
Language
  • English
Open access status
closed
Identifiers
Persistent URL
https://sonar.ch/global/documents/20318
Statistics
Document views: 23 File downloads: