spindle epithelial tumor with thymus-like differentiation tumor

**Characteristics of SET

Overview of SETTLE Tumor

Spindle epithelial tumor with thymus-like differentiation (SETTLE) is a rare neck malignancy that arises from thymic tissue or branchial pouch. The symptoms and signs of this tumor can vary, but here are some common manifestations:

• Neck Enlargement: One of the most common symptoms of SETTLE tumor is the presence of a neck mass, which can be hard, painless, and immobile (7) [number 7].
• Hoarseness: Some patients may experience hoarseness or difficulty speaking due to the tumor's location near the larynx (5) [number 5].
• Clinical Manifestations: The clinical manifestations of SETTLE tumor can include neck enlargement, hoarseness, and other symptoms related to the tumor's size and location (6) [number 6].

Diagnostic Features

The diagnostic features of SETTLE tumor are characterized by:

• Spindle Cells: Electron microscopic examination shows spindle cells with thymoma-like epithelial features, including prominent cytoplasmic tonofilaments, desmosomes, and other cellular structures (2) [number 2].
• Thymus-Like Differentiation: The tumor exhibits thymus-like differentiation, which is a key diagnostic feature of SETTLE (3) [number 3].

References

Please note that the information provided above is based on the search results and may not be an exhaustive list of symptoms and signs. If you have any further questions or would like more information, please let me know.

Citations: [1] by S Karaisli · 2020 · Cited by 11 [2] by AA Abdulrahman · 2018 · Cited by 6 [3] by AM Salih · 2024 [5] by D Lu · Cited by 2 [7] by EP Lincango Naranjo · 2022 · Cited by 1

Diagnostic Tests for Spindle Epithelial Tumor with Thymus-Like Differentiation (SETTLE)

Spindle epithelial tumor with thymus-like differentiation (SETTLE) is a rare and malignant biphasic neoplasm that can be challenging to diagnose. Here are some diagnostic tests that may be used to confirm the presence of SETTLE:

• Immunohistochemistry: This test is fundamental for diagnosing SETTLE, as it typically shows positivity for epithelial markers such as cytokeratin and vimentin [4]. Immunohistochemical staining can also help differentiate SETTLE from other types of tumors.
• Fine Needle Aspiration Cytology (FNAC): FNAC plays an important role in the diagnosis of all types of thyroid cancer, including SETTLE. However, it may not always provide a definitive diagnosis [6].
• Immunostaining: Immunostaining for calcitonin and chromogranin can be confirmatory of the diagnosis of SETTLE, as it is typically positive for these markers [7]. This test can also help differentiate SETTLE from thymoma.
• Histological examination: A histological examination of the tumor tissue is essential to diagnose SETTLE. It should show both spindle and epithelial components [3].
• Ultrasound-guided biopsy: An ultrasound-guided biopsy may be used to obtain a sample of the tumor tissue for further examination.

It's worth noting that the diagnosis of SETTLE can be challenging, and a combination of these diagnostic tests may be necessary to confirm the presence of this rare tumor.

Treatment Options for Spindle Epithelial Tumor with Thymus-Like Differentiation (SETTLE)

Spindle epithelial tumor with thymus-like differentiation (SETTLE) is a rare and malignant biphasic neoplasm of the thyroid or neck. While there are limited treatment options available, various

The differential diagnosis for Spindle Epithelial Tumor with Thymus-Like Differentiation (SETTLE) includes a group of tumors that have spindle and epithelial components, such as:

• Synovial sarcoma [9]
• Ectopic thymoma
• Carcinoma showing thymus-like differentiation (CASTLE)
• Spindle cell variant of medullary thyroid carcinoma
• Undifferentiated thyroid carcinoma
• Other soft tissue tumors including thymoma and carcinoma showing thymus-like differentiation (CASTLE) [2]

It's worth noting that SETTLE is a rare benign lesion, but it can be misdiagnosed due to its rarity and overlapping morphology with other close differential diagnoses [5]. Therefore, accurate diagnosis requires careful histopathological examination.

In addition, the differential diagnosis of SETTLE could also include cases of bulky thyroid mass extending to the mediastinum, as there is a possibility of late metastasis [7].

References:

[1] Chan and Rosai's proposal of SETTLE in 1991 [2] TM Stevens' article on differential diagnoses of SETTLE (2019) [5] P Chadha's article on misdiagnosis of SETTLE due to its rarity and overlapping morphology with other close differential diagnoses (2024) [7] S Lee's article on differential diagnosis of SETTLE in cases of bulky thyroid mass extending to the mediastinum (2018)