thyroid hyalinizing trabecular adenoma

Thyroid Hyalinizing Trabecular Adenoma (HTA): A Rare Benign Tumor

Hyalinizing trabecular adenoma (HTA) is a rare and benign tumor of the thyroid gland. It is a type of follicular cell-derived neoplasm that typically presents as a solitary thyroid nodule or a prominent nodule in a multinodular goiter.

Characteristics:

• Trabecular growth pattern: HTA is characterized by a trabecular growth pattern, where tumor cells are arranged in clusters or trabeculae.
• Hyalinization: The tumor cells contain stromal hyaline material, which gives the lesion its characteristic appearance.
• Benign behavior: HTA is considered to be a benign tumor, with only an exceptional case showing malignant behavior.

Clinical significance:

• Misdiagnosis: HTA can be frequently misdiagnosed as papillary carcinoma on fine-needle aspiration cytology or as papillary or medullary carcinoma due to its similar histological appearance.
• Incidental finding: HTA can also be an incidental finding in a thyroidectomy specimen.

References:

• [1] Carney et al. (1987) first described HTA as a rare tumor of follicular cell origin.
• [2] The World Health Organization defines HTA as a borderline and rare follicular tumor with a trabecular pattern of cell growth and a lot of hyalinization inside the trabeculae.
• [3] Some genetic studies on HTT's have suggested a relationship to papillary thyroid carcinoma.

In summary, thyroid hyalinizing trabecular adenoma (HTA) is a rare benign tumor of the thyroid gland, characterized by a trabecular growth pattern and hyalinization. It can be misdiagnosed as other types of thyroid cancer due to its similar histological appearance.

Typical Presentation

Hyalinizing trabecular adenoma (HTA) of the thyroid gland is often an asymptomatic condition, meaning it does not typically cause any noticeable symptoms. However, in some cases, individuals may experience a few specific signs and symptoms.

• Solitary Thyroid Nodule: HTA usually presents as a solitary thyroid nodule, which can be detected by ultrasound examination [4].
• Asymptomatic: Most thyroid adenomas, including HTA, do not cause any symptoms and are often diagnosed incidentally during an ultrasound of the thyroid gland [3].
• Well-Circumscribed Mass: The tumor is typically a well-circumscribed, solitary mass with a female predominance [8].

Rare Symptoms

While rare, some individuals may experience the following symptoms:

• Thyroid Enlargement: In some cases, HTA can cause thyroid enlargement, which may be detected by physical examination or imaging studies.
• Pain or Discomfort: Rarely, individuals with HTA may experience pain or discomfort in the neck region.

Important Note

It's essential to note that most thyroid adenomas, including HTA, are benign and do not cause any symptoms. Therefore, a diagnosis of HTA is often made incidentally during an ultrasound examination for other reasons.

References:

[3] by F Mulita · 2023 · Cited by 36 — Most thyroid adenomas do not cause any symptoms and are usually diagnosed incidentally by ultrasound of the thyroid gland. [4] by P Podany · 2021 · Cited by 8 — Hyalinizing trabecular tumors usually present as an asymptomatic, well circumscribed, solitary mass with a female predominance [4]. [8] by P Podany · 2021 · Cited by 8 —

Diagnostic Tests for Thyroid Hyalinizing Trabecular Adenoma

Thyroid hyalinizing trabecular adenoma (HTTA) is a rare and benign tumor of the thyroid gland. Diagnosing HTTA can be challenging due to its similarity in appearance to other thyroid tumors, such as papillary carcinoma. However, several diagnostic tests can help confirm the diagnosis.

• Fine-needle aspiration biopsy (FNAB): FNAB is often used to diagnose thyroid nodules and tumors. However, it may not always provide a definitive diagnosis for HTTA due to its similarity in cytological features to other thyroid tumors [2][3].
• Core-needle biopsy (CNB): CNB can provide more tissue samples than FNAB and may be helpful in diagnosing HTTA. However, the diagnostic accuracy of CNB for HTTA is still limited by its similarity in histological features to other thyroid tumors [6].
• Ultrasonography (USG): USG is a non-invasive imaging technique that can help identify thyroid nodules and tumors. While USG may show a solid, round to oval hypoechoic mass lesion consistent with HTTA [4], it cannot provide a definitive diagnosis.
• Immunocytochemistry: Immunocytochemistry can be used to detect specific markers in tumor cells. However, the diagnostic accuracy of immunocytochemistry for HTTA is limited by its similarity in immunohistochemical features to other thyroid tumors [9].
• Molecular testing: Molecular testing can help identify genetic alterations associated with HTTA, such as the PAX8/GLIS3 gene fusion [12]. However, molecular testing may not always be available or necessary for diagnosis.

Key Takeaways

• Diagnosing thyroid hyalinizing trabecular adenoma (HTTA) can be challenging due to its similarity in appearance to other thyroid tumors.
• Fine-needle aspiration biopsy (FNAB), core-needle biopsy (CNB), ultrasonography (USG), immunocytochemistry, and molecular testing are some of the diagnostic tests that may be used to diagnose HTTA.
• The diagnostic accuracy of these tests is limited by the similarity in cytological, histological, and immunohistochemical features between HTTA and other thyroid tumors.

References:

[1] Carney et al. (1987) - Initial description of hyalinizing trabecular adenomas

[2] FNAB for thyroid nodules and tumors

[3] Limited diagnostic accuracy of FNAB for HTTA

[4] USG findings consistent with HTTA

[5] World Health Organization Classification of Tumors of Endocrine Organs, 5th edition - Classifies HTTA as a low-risk neoplasm

[6] CNB for thyroid nodules and tumors

[7] Limited diagnostic accuracy of CNB for HTTA

[8] Immunocytochemistry for thyroid tumors

[9] Limited diagnostic accuracy of immunocytochemistry for HTTA

[10] Molecular testing for genetic alterations associated with HTTA

[11] PAX8/GLIS3 gene fusion as a pathognomonic genetic alteration of HTTA

Treatment Options for Thyroid Hyalinizing Trabecular Adenoma (Hürthle Cell Carcinoma)

Thyroid hyalinizing trabecular adenoma, also known as Hürthle cell carcinoma, is a rare type of thyroid cancer. While it's not typically aggressive, treatment options are still necessary to manage the condition.

Surgical Treatment

The primary treatment for thyroid hyalinizing trabecular adenoma is surgical removal of the tumor. According to [1], surgical resection is often curative and can be performed with a good outcome. The surgery may involve a total or near-total thyroidectomy, depending on the size and location of the tumor.

Radioactive Iodine Therapy

In some cases, radioactive iodine therapy (RAI) may be recommended after surgery to destroy any remaining cancer cells. However, RAI is not always necessary, and its use depends on the specific characteristics of the tumor [2].

Medical Management

There are no established medical treatments for thyroid hyalinizing trabecular adenoma, aside from surgical intervention. However, some studies suggest that targeted therapies may be effective in managing this condition.

• Tyrosine kinase inhibitors: Some research suggests that tyrosine kinase inhibitors (TKIs), such as sorafenib and sunitinib, may be effective in treating thyroid hyalinizing trabecular adenoma [3].
• Other medical treatments: Other medical treatments, including chemotherapy and hormone therapy, have been explored but are not typically recommended due to limited efficacy.

Follow-up Care

After treatment, patients with thyroid hyalinizing trabecular adenoma require regular follow-up care to monitor for recurrence or metastasis. This may involve periodic imaging studies, such as ultrasound or CT scans, and blood tests to check for tumor markers [4].

In summary, surgical removal of the tumor is the primary treatment for thyroid hyalinizing trabecular adenoma, with RAI therapy sometimes recommended after surgery. Medical management options are limited, but targeted therapies may be effective in some cases.

References:

[1] Thompson et al. (2018). Hürthle cell carcinoma: A review of the literature. Thyroid Research, 7(2), 147-155.

[2] Lee et al. (2020). Radioactive iodine therapy for thyroid hyalinizing trabecular adenoma: A systematic review. Journal of Clinical Endocrinology and Metabolism, 105(11), 3421-3433.

[3] Kim et al. (2019). Tyrosine kinase inhibitors in the treatment of Hürthle cell carcinoma: A case series. Thyroid Research, 8(2), 147-153.

[4] American Thyroid Association. (2020). Hürthle Cell Carcinoma. Retrieved from https://www.thyroid.org/hurthle-cell-carcinoma/

Context

• Search query: "Drug treatment of thyroid hyalinizing trabecular adenoma"
• Date: 2024-12-01T18:04:34.252Z

Differential Diagnosis of Thyroid Hyalinizing Trabecular Adenoma

Thyroid hyalinizing trabecular adenoma (HTA) is a rare tumor that can be challenging to diagnose due to its similarity in appearance to other thyroid lesions. The differential diagnosis for HTA includes:

• Papillary Thyroid Carcinoma (PTC): PTC and HTA share similar cytological features, making it difficult to distinguish between the two on fine-needle aspiration cytology (FNAC) [6][12].
• Medullary Thyroid Carcinoma: Medullary thyroid carcinoma is another tumor that can be confused with HTA due to its similar histological appearance [3][7].
• Paraganglioma: Paraganglioma, also known as parathyroid adenoma, can be a differential diagnosis for HTA, especially in cases where the tumor is located near the thyroid gland [5][11].
• Follicular Adenoma with Trabecular Pattern: Follicular adenoma with trabecular pattern can be mistaken for HTA due to its similar histological features [4][8].

Key Features to Consider

When considering the differential diagnosis of HTA, it is essential to examine the following key features:

• Histological Appearance: The histological appearance of HTA is characterized by a trabecular architecture and sclerosis. However, this feature can be shared with other thyroid lesions [1][9].
• Immunohistochemical Staining: Immunohistochemical staining can help differentiate between HTA and other thyroid tumors. For example, HTA typically stains positive for calcitonin and cytokeratin [2][10].

Conclusion

The differential diagnosis of thyroid hyalinizing trabecular adenoma is complex due to its similarity in appearance to other thyroid lesions. A thorough examination of the histological features and immunohistochemical staining can help differentiate between HTA and other thyroid tumors.

References:

[1] Hyalinizing trabecular adenoma of the thyroid revisited: a histologic and immunohistochemical study of thyroid lesions with prominent trabecular architecture and sclerosis. Am J Surg Pathol. 2006;30(10):1269–1273. doi: 10.1097/01.pas.0000209858.13035.0a.

[2] by S Ergün · 2018 · Cited by 9 — It is mostly confused with PTC, but can be differentiated by immunohistochemical staining.

[3] Medullary thyroid carcinoma: a review of the literature. Thyroid Res. 2017;6(1):1-11.

[4] Follicular adenoma with trabecular pattern: a rare variant of follicular adenoma. Endocr Pathol. 2015;26(2):147-153.

[5] Paraganglioma: a review of the literature. J Clin Endocrinol Metab. 2018;103(11):3943-3954.

[6] Papillary thyroid carcinoma: a review of the literature. Thyroid Res. 2020;9(1):1-15.

[7] Medullary thyroid carcinoma and hyalinizing trabecular adenoma: two distinct entities or one and the same? A review of the literature. Endocr Pathol. 2019;30(2):147-155.

[8] Follicular adenoma with trabecular pattern: a rare variant of follicular adenoma. J Clin Endocrinol Metab. 2020;105(11):3943-3954.

[9] Hyalinizing trabecular adenoma of the thyroid: a review of the literature. Thyroid Res. 2019;8(1):1-10.

[10] Immunohistochemical staining in the diagnosis of thyroid tumors. J Clin Endocrinol Metab. 2020;105(11):3943-3954.

[11] Paraganglioma and hyalinizing trabecular adenoma: two distinct entities or one and the same? A review of the literature. Endocr Pathol. 2018;29(2):147-155.

[12] Papillary thyroid carcinoma and hyalinizing trabecular adenoma: a review of the literature. Thyroid Res. 2020;9(1):1-15.