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Fatal sporadic medullary carcinoma of the thyroid

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Abstract

Thirteen cases of fatal sporadic medullary carcinoma of the thyroid (MCT) that killed the patient within 1 year after diagnosis were compared with 12 nonfatal MCTs with excellent prognosis. Males predominated in fatal cases whereas the reverse was true in MCTs with good prognosis. The two groups of tumors showed generally similar cytoarchitectural features. Outstanding features of fatal MCTs, as compared with nonfatal ones, included more cellular atypia, less frequent amyloid stroma and calcification, higher mitotic rate, tumor necrosis, and a generally lower proportion of neoplastic cells stained for calcitonin. We believe that the morphological features based on routine histological studies, together with immunohistochemistry, should be reported by the pathologist since they could be useful for the management and follow-up of patients with MCT.

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References

  1. Alborcs-Saavcdra J, LiVolsi VA, Williams ED. Medullary carcinoma. Semin Diagn Pathol 2:137–146, 1985.

    Google Scholar 

  2. Bcrgholm U, Adami HO, Bergstrorn R, Johansson H, Lundell G, Telenius-Berg M, Akerstrom G, and the Swedish MTC study group. Clinical characteristics in sporadic and familial medullary thyroid carcinoma. A nationwide study of 249 patients in Sweden from 1959 through 1981. Cancer 63:1196–1204, 1989.

    Article  Google Scholar 

  3. Carcangiu ML, Zampi G, Rosai J. Poorly differentiated (“insular”) thyroid carcinoma. A reinterpretation of Langhans’ wuchernde Struma. Am J Surg Pathol 8:655–668, 1984.

    Article  CAS  Google Scholar 

  4. Driman D, Murray D, Kovacs K, Ste-faneanu L, Higgins HP. Encapsulated medullary carcinoma of the thyroid. A morphologic study including immunocytochemistry, electron microscopy, flow cytometry, and in situ hybridization. Am J Surg Pathol 15:1089–1095, 1991.

    Article  CAS  Google Scholar 

  5. Eusebi V, Damiani S, Riva S, Lloyd RV, Capella C. Calcitonin free oat-cell carcinoma of the thyroid gland. Virchows Arch [A] 417:267–271, 1990.

    Article  CAS  Google Scholar 

  6. Harach HR. Thyroid follicles with acid mucin in man. A second kind of follicles? Cell Tissue Res 242:211–215, 1985.

    Article  CAS  Google Scholar 

  7. Harach HR, Bergholm U. Medullary (C cell) carcinoma of the thyroid with features of follicular oxyphilic cell tumours. Histopathology 12:645–656, 1988.

    Google Scholar 

  8. Harach HR, Bergholm U. Medullary carcinoma of the thyroid with carcinoid-like features. J Clin Pathol (in press).

  9. Harach HR, Franssila KO. Thyroglobulin immunostaining in follicular thyroid carcinoma: relationship to the degree of differentiation and cell type. Histopathology 13:43–54, 1988.

    Article  CAS  Google Scholar 

  10. Harach HR, Wilander E, Grimelius L, Bergholm U, Westermark P, Falkmer S. Chromogranin A immunoreactivity compared with argyrophilia, calcitonin immunoreactivity, and amyloid as tumour markers in the histopathological diagnosis of medullary (C-cell) thyroid carcinoma. Pathol Res Pract 188:123–130, 1992.

    Article  CAS  Google Scholar 

  11. Harach HR, Williams ED. Glandular (tubular and follicular) variants of medullary carcinoma of the thyroid. Histopathology 7:83–97, 1983.

    Article  CAS  Google Scholar 

  12. Hedinger C, Williams ED, Sobin LH. Histological typing of thyroid tumours. In: International histological classification of tumours, 2nd ed. Geneva: Springer-Verlag, 1988:11–13.

    Google Scholar 

  13. Kakudo K, Miyauchi A, Katayama S, Watanabe K. Ultrastructural study of poorly differentiated medullary carcinoma of the thyroid. Virchows Arch [A] 410:455–460, 1987.

    Article  CAS  Google Scholar 

  14. Kakudo K, Miyauchi A, Ogihara T, Takai SI, Kitamura H, Kosaki G, Kumahara Y. Medullary carcinoma of the thyroid. Giant cell type. Arch Pathol Lab Med 102:445–447, 1978.

    CAS  PubMed  Google Scholar 

  15. Martinelli G, Bazzocchi F, Govoni E, Santini D. A naplastic type of medullary thyroid carcinoma. An ultrastructural and immunohistochemical study. Virchows Arch [A] 400:61–67, 1983.

    Article  CAS  Google Scholar 

  16. Mendelsohn G, Bigner SH, Eggleston JC, Baylin SB, Wells SA Jr. Anaplastic variants of medullary thyroid carcinoma. A lightmicroscopicandimmunohistochemicalstudy. Am J Surg Pathol 4:333–341, 1980.

    Article  CAS  Google Scholar 

  17. Mendelsohn G, Wells SA Jr, Baylin SB. Relationship of tissue carcinoembryonic antigen and calcitonin to tumor virulence in medullary thryoid carcinoma. An immunohistochemical study in early, localized, and virulent disseminated stages of disease. Cancer 54:657–662, 1984.

    Article  CAS  Google Scholar 

  18. Nicuwcnhuijzcn Kruseman AC, Bosman FT, van Bergen Henegouw JC, CramerKnijnenburg G, de la Riviere GB. Medullary differentiation of anaplastic thyroid carcinoma. Am J Clin Pathol 77:541–547, 1982.

    Article  Google Scholar 

  19. Rougier P, Calmettes C, Laplanche A, Travagli JP, Lefevre M, Parmentier C, Milhaud G, Tubiana M. The values of calcitonin and carcinoembryonic antigen in the treatment and management of nonfamilial medullary thyroid carcinoma. Cancer 51:855–862, 1983.

    Article  CAS  Google Scholar 

  20. Rougier P, Parmentier C, Laplanche A, Lefevre M, Travagli JP, Caillou B, Schlumberger M, Lacour J, Tubiana M. Medullary thyroid carcinoma: prognostic factors and treatment. Int J Rad Oncol Biol Phys 9:161–169, 1983.

    Article  CAS  Google Scholar 

  21. Ruppert JM, Eggleston JC, deBustros A, Baylin SB. Disseminated calcitonin-poor medullary thyroid carcinoma in a patient with calcitonin-rich primary tumor. Am J Surg Pathol 10:513–518, 1986.

    Article  CAS  Google Scholar 

  22. Saad MF, Ordonez NG, Rashid RK, Guido JJ, Hill CS Jr, Hickey RC, Samaan NA. Medullary carcinoma of the thyroid. A study of the clinical features and prognostic factors in 161 patients. Medicine 63:319–342, 1984.

    Article  CAS  Google Scholar 

  23. Schroder S, Bocker W, Baisch H, Burk CG, Arps H, Meiners I, Kastendieck H, Heitz PU, Kloppel G. Prognostic factors in medullary thyroid carcinomas. Survival in relation to age, sex, stage, histology, immunocytochemistry, and DNA content. Cancer 61:806–816, 1988.

    Article  CAS  Google Scholar 

  24. Tubiana M, Parmantier G, Gerard-Marchant R, Lacour J, Milhaud G, Bok B, Weiler J. Etude comparative des epitheliomas medullaires du corps thyroide avec et sans stroma amyloide. Eur J Cancer 6:39–47, 1970.

    Article  CAS  Google Scholar 

  25. Williams ED, Brown CL, Doniach I. Pathological and clinical findings in a series of 67 cases of medullary carcinoma of the thyroid. J Clin Pathol 19:103–113, 1966.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Departments of Pathology (HRH) and Surgery (UB), University Hospital, University of Uppsala, Uppsala, Sweden

    H. Ruben Harach & Ulla Bergholm

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  1. H. Ruben Harach
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  2. Ulla Bergholm
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Harach, H.R., Bergholm, U. Fatal sporadic medullary carcinoma of the thyroid. Endocr Pathol 4, 53–59 (1993). https://doi.org/10.1007/BF02914490

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  • DOI: https://doi.org/10.1007/BF02914490

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