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Cutaneous metastasis from anaplastic thyroid carcinoma exhibiting exclusively a spindle cell morphology. A case report and review of literature
- Source :
- Journal of Cutaneous Pathology. 43:252-257
- Publication Year :
- 2015
- Publisher :
- Wiley, 2015.
-
Abstract
- Anaplastic thyroid carcinoma is a highly aggressive cancer accounting for 1-2% of thyroid malignancies. Cutaneous metastases from anaplastic thyroid carcinoma are exceedingly rare. We report a 65-year-old woman with anaplastic thyroid carcinoma (BRAF V600E mutation) who had lymph node metastases (pT4 N1b) treated by total thyroidectomy, postoperative radiotherapy, adjuvant chemotherapy (paclitaxel and pazopanib) and targeted therapy (vemurafenib). Nine months after initial diagnosis, radiographic studies revealed multiple pulmonary metastases. A dermatologic examination showed a solitary 1.2-cm chest nodule. Skin biopsy from this nodule revealed infiltrative dermal spindle cells arranged in poorly formed fascicles. Immunohistochemical studies demonstrated the tumor cells to be PAX-8 (+), pancytokeratin (+, focally), TTF-1 (-) and SOX-10 (-). Comparison with the patient's primary anaplastic thyroid carcinoma revealed focal areas of poorly differentiated spindle cells morphologically similar to the malignant spindle cells in the skin biopsy. Together, these findings confirmed the diagnosis of anaplastic thyroid carcinoma metastatic to skin. Cutaneous metastasis of anaplastic thyroid carcinoma composed exclusively of spindle cells broadens the histologic differential diagnosis of cutaneous spindle cell malignancies and presents further diagnostic challenges. PAX-8 may be useful in discerning the spindle cell component of anaplastic thyroid carcinoma from other spindle cell malignancies in the skin.
- Subjects :
- endocrine system
Pathology
medicine.medical_specialty
Histology
medicine.diagnostic_test
business.industry
Thyroid
Dermatology
medicine.disease
Cell morphology
Pathology and Forensic Medicine
Pazopanib
030207 dermatology & venereal diseases
03 medical and health sciences
0302 clinical medicine
medicine.anatomical_structure
030220 oncology & carcinogenesis
Skin biopsy
medicine
Sarcoma
Differential diagnosis
Vemurafenib
business
Lymph node
medicine.drug
Subjects
Details
- ISSN :
- 03036987
- Volume :
- 43
- Database :
- OpenAIRE
- Journal :
- Journal of Cutaneous Pathology
- Accession number :
- edsair.doi...........eb5cb91630b535263fa639ce2f5d471d