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Poorly Differentiated Thyroid Carcinoma

  • Massimo Bongiovanni
  • William C. Faquin
Chapter

Abstract

Poorly differentiated thyroid carcinoma (PDTC) was first proposed as a distinct subtype of thyroid malignancy by Carcangiu et al. These authors reinterpreted the original observation made in 1907 by Langhans, who described a locally aggressive tumor with a peculiar architecture: tumor cells arranged in large, round to oval formations, the so-called “insulae.” Currently, there are 2 recognized subtypes of PDTC - insular and non-insular. PDTC is a rare malignancy, accounting for 4–7% of all thyroid cancers. It has an aggressive clinical behavior intermediate between that of the well differentiated thyroid carcinomas (papillary carcinoma, follicular carcinoma, and Hürthle cell carcinoma) and undifferentiated (anaplastic) thyroid carcinoma. PDTCs often present at an advanced stage, have a propensity for local recurrence, and tend to metastasize to regional lymph nodes, lung, and bones. The mean 5-year survival of patients with PDTC is approximately 50%. Well differentiated thyroid carcinomas with a focal (10% or greater) PDTC component follow a more aggressive clinical course than standard well differentiated carcinomas of the thyroid.

Keywords

Thyroid Cancer Thyroid Carcinoma Papillary Thyroid Carcinoma Papillary Carcinoma Medullary Thyroid Carcinoma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Carcangiu ML, Zampi G, Rosai J. Poorly differentiated (“insular”) thyroid carcinoma. A reinterpretation of Langhans’ “wuchernde struma”. Am J Surg Pathol 1984;8(9):655-668.Google Scholar
  2. 2.
    Langhans T. Uber die epithelialen formen der malignen struma. Virchows Arch (A). 1907;189:69-188.Google Scholar
  3. 3.
    Sobrinho Simoes M, Albores-Saavedra J, Tallini G, et al. Poorly differentiated carcinoma. In: DeLellis R, Lloyd RV, Heitz PU, Eng C, eds. World Health Organization Classification of Tumours: Pathology and Genetics of Tumours of Endocrine Organs. Lyon: IARC Press 2004.Google Scholar
  4. 4.
    Volante M, Landolfi S, Chiusa L, et al. Poorly differentiated carcinomas of the thyroid with trabecular, insular, and solid patterns: a clinicopathologic study of 183 patients. Cancer. 2004;100(5):950-957.CrossRefPubMedGoogle Scholar
  5. 5.
    Decaussin M, Bernard MH, Adeleine P, et al. Thyroid carcinomas with distant metastases: a review of 111 cases with emphasis on the prognostic significance of an insular component. Am J Surg Pathol. 2002;26(8):1007-1015.CrossRefPubMedGoogle Scholar
  6. 6.
    Bedrossian CWM, Martinez F, Silverberg AB. Fine needle aspiration. In: Gnepp DR, ed. Pathology of the head and neck. New York: Churchill Livingstone; 1988:25-99.Google Scholar
  7. 7.
    Flynn SD, Forman BH, Stewart AF, et al. Poorly differentiated (“insular”) carcinoma of the thyroid gland: an aggressive subset of differentiated thyroid neoplasms. Surgery. 1988;104(6):963-970.PubMedGoogle Scholar
  8. 8.
    Pietribiasi F, Sapino A, Papotti M, et al. Cytologic features of poorly differentiated ‘insular’ carcinoma of the thyroid, as revealed by fine-needle aspiration biopsy. Am J Clin Pathol. 1990;94:687-692.PubMedGoogle Scholar
  9. 9.
    Sironi M, Collini P, Cantaboni A. Fine needle aspiration cytology of insular thyroid carcinoma: a report of four cases. Acta Cytol. 1992;36:435-439.PubMedGoogle Scholar
  10. 10.
    Guiter GE, Auger M, Ali SZ, et al. Cytopathology of insular carcinoma of the thyroid. Cancer (Cancer Cytopathol). 1999;87:196-202.Google Scholar
  11. 11.
    Nguyen GK, Akin M-RM. Cytopathology of insular carcinoma of the thyroid. Diagn Cytopathol. 2001;25:325-330.CrossRefPubMedGoogle Scholar
  12. 12.
    Oertel YC, Miyahara-Felipe L. Cytologic features of insular carcinoma of the thyroid: a case report. Diagn Cytopathol. 2006;34(8):572-575.CrossRefPubMedGoogle Scholar
  13. 13.
    Zakowski MF, Schlesinger K, Mizrachi HH. Cytologic features of poorly differentiated “insular” carcinoma of the thyroid. A case report. Acta Cytol 1992;36(4):523-526.Google Scholar
  14. 14.
    Bongiovanni M, Bloom L, Krane JF, et al. Cytomorphologic features of poorly differentiated thyroid carcinoma. A multi-institutional analysis of 40 cases. Cancer (Cancer Cytopathol) 2009;117(3):185-194.Google Scholar
  15. 15.
    Sanders EM Jr, LiVolsi VA, Brierley J, et al. An evidence-based review of poorly differentiated thyroid cancer. World J Surg. 2007;31(5):934-945.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Massimo Bongiovanni
    • 1
  • William C. Faquin
    • 2
  1. 1.Department of PathologyGeneva University HospitalGenevaSwitzerland
  2. 2.Department of PathologyMassachusetts General Hospital and Harvard Medical SchoolBostonUSA

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