engleski

Case report of a primary mucoepidermoid carcinoma of thyroid with extensive metastases

Mucoepidermoid carcinoma of the thyroid (MECT) is rare condition, with about 20 cases reported in the English literature. To our knowledge this report presents the first such case ever recorded in a Croatian patient. A 33-year-old male presented with rapidly enlarging mass in left thyroid lobe. Cytologic analysis suggested poorly differentiated thyroid carcinoma and total thyroidectomy was performed. Resected lobe measured 6.0x5.0x3.0 cm, while sectioning revealed, a poorly circumscribed graywhite tumor (ř 5.5 cm). Light microscopy showed atypical, large, epithelial cells forming solid islands and nests, with variable focall production of mucin. Squamous cells foci without keratinization were also observed. Up to 5 mitotic figures per 10 HPF were found. Tumor was immunohistochemicaly negative for thyroglobulin and calcitonin. Mucin-producing cells were alcian blue-positive. Electron microscopy showed squamous cells with intracytoplasmatic aggregates of tonofilaments, well-developed desmosomal attachments and mucous cells characterised by numerous mucin granules. MECT are usually of low-grade malignant potential, however presented case demonstrated an aggressive clinical course. Six months after initial treatment ipsilateral radical neck dissection was urged due to neck lymph node metastases (positive 25/44 resected l. n.). One month later CT revealed large tumor located behind the larynx, compressing the trachea, with retrosternal spread into the mediastinum. After 2 months urgent tracheostomy was performed, and external radio-therapy was applied with palliative effect. We conclude that in METC with aggressive clinical course surgery should be treatment of choice, while in poorly differentiated tumors external radiotherapy might be applied. Reporting of such cases is advisable in order to enlarge general experience in dealing with rare, aggressive forms of thyroid neoplasms

Case report of a primary mucoepidermoid carcinoma of thyroid with extensive metastases

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