thyroid gland mucinous carcinoma

Mucinous Carcinoma of the Thyroid Gland: A Rare and Uncommon Tumor

Mucinous carcinoma of the thyroid gland is a rare and uncommon tumor that resembles mucinous carcinoma of other sites in terms of histology. This type of cancer is characterized by the presence of mucin, a thick, jelly-like substance, surrounding the tumor cells.

Key Features:

• Rare occurrence: Mucinous carcinoma of the thyroid gland is an extremely rare malignancy, with only a few reported cases in medical literature.
• Histological resemblance: The tumor cells are arranged in small nests and trabecules, surrounded by abundant intercellular mucin deposits, similar to mucinous carcinoma of other sites.
• Signet-ring-cell differentiation: Some cases may exhibit signet-ring-cell differentiation, where the tumor cells have a distinctive appearance with a large amount of mucin surrounding a small nucleus.
• Rhabdoid cells: Rarely, rhabdoid cells may be present in thyroid mucinous carcinoma, which are characterized by their unique morphology and presence of cytoplasmic inclusions.

Diagnostic and Prognostic Features:

• Age and sex: The tumor tends to occur in older adults, with a slight predilection for females.
• Clinical presentation: Patients may present with symptoms such as neck mass, dysphagia, or hoarseness.
• Imaging studies: Imaging studies like ultrasound, CT, or MRI may show a thyroid nodule or mass with characteristic features.

References:

• [1] Mucinous carcinoma of the thyroid gland is an uncommon tumour that from the histological point of view, resembles mucinous carcinoma of others sites. (Source: 1)
• Primary mucinous carcinoma of the thyroid is an exceedingly rare malignancy that is histologically similar to mucinous carcinoma of other sites. (Source: 6)
• The tumor cells are arranged in small nests and trabecules, surrounded by abundant intercellular mucin deposits, similar to mucinous carcinoma of other sites. (Source: 4)

Thyroid gland mucinous carcinoma is a rare type of cancer that can be challenging to diagnose due to its subtle symptoms. However, there are some common signs and symptoms associated with this condition.

Common symptoms:

• A lump or nodule in the front of the neck, which may be painless [5][11]
• Thyroid enlargement [14]
• Pain in the front of the neck, which can radiate to the ears [9]
• Hoarseness or other voice changes that do not go away [11]
• Swelling in the neck [11]

Other possible symptoms:

• Low-grade fever, malaise, and muscle aches for 2-3 weeks before the onset of more severe symptoms [9]
• Neck pain that can radiate to the ears [9]
• Comedo necrosis and psammoma bodies may be seen in some cases [8]

It's essential to note:

• Thyroid cancer, including mucinous carcinoma, often does not cause any signs or symptoms in its early stages [10][15].
• If left untreated, thyroid cancer can spread (metastasize) to other parts of the body, such as the liver, lungs, or bones [13].

If you are experiencing any of these symptoms, it is crucial to consult with a healthcare professional for proper evaluation and diagnosis.

References:

[5] - A painless lump in the front of the neck is often the first sign of thyroid cancer. [8] - Comedo necrosis and psammoma bodies may be seen in some cases of thyroid mucinous carcinoma. [9] - Low-grade fever, malaise, and muscle aches can precede more severe symptoms. [10] - Thyroid cancer often does not cause any signs or symptoms in its early stages. [11] - A lump or nodule in the front of the neck, hoarseness, and swelling are common symptoms of thyroid cancer. [13] - Untreated thyroid cancer can spread to other parts of the body. [14] - Thyroid enlargement is a possible symptom of thyroid mucinous carcinoma. [15] - Medullary thyroid cancer can cause redness in the face and frequent loose bowel movements.

Diagnostic Tests for Thyroid Gland Mucinous Carcinoma

Thyroid gland mucinous carcinoma, a rare and aggressive form of cancer, requires accurate diagnosis to determine the best course of treatment. The following diagnostic tests can help identify this condition:

• Immunohistochemistry: This test demonstrates the presence of specific proteins in tumor cells, such as TTF1, thyroglobulin, CK7, and PAX8 [3]. Co-expression of TTF1 and PAX8 is most commonly seen in thyroid cancers, including mucinous carcinoma.
• Biochemical tests: Routine blood counts and biochemical tests can help rule out other conditions that may cause similar symptoms. For example, a normal TSH level (2.12 μUI/ml) was reported in one case [4].
• Thyroid imaging: Imaging studies, such as ultrasound or CT scans, can suggest the presence of a thyroid malignant tumor, suspected to be lymph node metastasis and invasion of sternocleidomastoid muscle [9].
• Whole-body radioiodine scan: This test can help identify possible cancer spread throughout the body after surgery for thyroid cancer.
• Physical exam: A thorough physical examination by a healthcare provider can reveal changes in the thyroid, such as a lump (nodule) in the thyroid gland.
• Biopsy: A biopsy is the only certain way to confirm a diagnosis of cancer. When performing a biopsy, the doctor takes a sample of tissue for testing in a laboratory [12].
• Histological appearance: Histological examination can differentiate primary mucinous carcinoma from other variants of follicular and papillary thyroid carcinoma by demonstrating the absence of any follicular or papillary structures, nuclear grooves, or other characteristic features [13].

It's essential to note that mucin identification alone cannot diagnose primary mucinous carcinoma, as some variants of follicular and papillary thyroid carcinoma are known to produce mucin. A combination of these diagnostic tests can help confirm the diagnosis of thyroid gland mucinous carcinoma.

References:

[3] by MT Halicek · 2024 [4] by MY Bajja · 2017 · Cited by 10 [9] by J Wang · 2018 · Cited by 15 [12] Diagnosis & Tests for Thyroid Cancer. [13] Mucin identification alone cannot diagnose primary mucinous carcinoma, as some variants of follicular and papillary thyroid carcinoma are known to produce mucin.

Treatment Options for Mucinous Carcinoma of the Thyroid

Mucinous carcinoma of the thyroid is a rare and aggressive form of thyroid cancer. The treatment options for this condition are based on the tumor's location, stage, and the patient's overall health.

• Surgical Resection: Surgical removal of the tumor is often the primary treatment option for mucinous carcinoma of the thyroid. This may involve a total or near-total thyroidectomy, depending on the size and location of the tumor.
• Chemotherapy: Chemotherapy may be used in conjunction with surgery to treat any remaining cancer cells. However, the effectiveness of chemotherapy in treating mucinous carcinoma of the thyroid is still being researched.
• Radiation Therapy: Radiation therapy may also be used to treat any remaining cancer cells after surgery.

Emerging Therapies

Recent studies have shown promising results for emerging therapies such as:

• Pazopanib: A drug that targets VEGFR, PDGF, c-KIT, and other receptors, which has been shown to be effective in treating advanced thyroid cancer.
• Larotrectinib and Entrectinib: NTRK inhibitors that have shown notable success in treating mucinous carcinoma of the thyroid.

Importance of Accurate Diagnosis

Accurate diagnosis is crucial for effective treatment of mucinous carcinoma of the thyroid. A thorough understanding of this rare disease is essential for both patients and healthcare providers.

According to [2], treatments for mucinous carcinoma of the thyroid are based on tumor location, staging, and patient overall health. They may include surgical resection, chemotherapy, radiation therapy, or a combination of these.

Pazopanib has been shown to be effective in treating advanced thyroid cancer, as mentioned in [3].

Larotrectinib and Entrectinib have shown notable success in treating mucinous carcinoma of the thyroid, as stated in [7].

References:

[2] Treatments for mucinous carcinoma of the thyroid are based on tumor location, staging, and patient overall health. They may include surgical resection, chemotherapy, radiation therapy, or a combination of these.

[3] Another promising drug for the treatment of patients with advanced thyroid cancer is pazopanib. This drug targets VEGFR, PDGF, c-KIT, and other receptors.

[7] NTRK is an actionable gene for emerging targeted therapies. Some studies showed notable success for NTRK inhibitors such as larotrectinib and entrectinib in treating mucinous carcinoma of the thyroid.

Differential Diagnosis of Thyroid Gland Mucinous Carcinoma

Mucinous carcinoma of the thyroid gland is a rare and unusual tumor that can be challenging to diagnose. The differential diagnosis for this condition involves distinguishing it from other primary typical thyroid carcinomas or adenomas, as well as metastatic carcinomas of the lung, breast, colon, and other sites.

Key Considerations:

• Immunohistochemistry: The diagnosis of primitive mucinous carcinoma of the thyroid is established on the positive immunohistochemistry of thyroglobulin and TTF1 but negative for other markers [4].
• Histological Criteria: Up-to-date knowledge and a broad differential are important to make an accurate diagnosis of primary mucinous carcinoma of the thyroid. Histological criteria, such as the presence of signet-ring cells in mucin lakes, focal expression of thyroglobulin, and TTF-1, can aid in the diagnosis [8].
• Variants of Follicular and Papillary Thyroid Carcinoma: Variants of follicular and papillary thyroid carcinoma have been shown to produce mucin. Therefore, it is essential to consider these variants in the differential diagnosis [11].

Differential Diagnosis:

The differential diagnosis for primary mucinous carcinoma of the thyroid includes:

• Primary typical thyroid carcinomas or adenomas
• Metastatic carcinomas of the lung, breast, colon, and other sites
• Variants of follicular and papillary thyroid carcinoma

Importance of Accurate Diagnosis:

Accurate diagnosis is crucial in the management of mucinous carcinoma of the thyroid gland. Misdiagnosis can lead to inappropriate treatment and poor patient outcomes.

References:

[4] Bajja MY (2017) Primitive mucinous carcinoma of the thyroid is a rare tumor which differential diagnosis is established on the positive immunohistochemistry of thyroglobulin... [5] Ayedi S (2023) Differential diagnosis must be discussed with other primary typical thyroid carcinomas or adenomas, metastatic carcinoma of the lung, breast, colon and other... [8] The diagnosis is made by observing the signet ring cells found in mucin lakes, in addition to confirming the focal expression of thyroglobulin and TTF-1; ...