Skip to main content
SpringerLink
Log in

Clinicopathologic Features and Outcomes in Patients with Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma

  • Original Scientific Report
  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Background

Diffuse sclerosing variant (DSV) of papillary thyroid carcinoma (PTC) is a rare variant more common among younger patients.

Materials and methods

Excluding patients with microcarcinoma, 5848 patients with PTC underwent initial surgery between 1995 and 2011. Twenty-two patients (0.4 %) were histologically diagnosed with DSV, of whom 20 (91 %) were <45 years old. We compared clinicopathologic characteristics and outcomes between patients with DSV and those with classical PTC <45 years old. Univariate analysis by the Kaplan–Meier method in relation to cause-specific survival (CSS) and disease-free survival (DFS) rates was performed with regard to the following variables: sex; anti-thyroglobulin antibody (TgAb) positivity; presence of distant metastasis; pathological lymph node metastasis; extra-thyroidal invasion; and pathological variant (classical vs. DSV).

Results

The 20 patients with DSV <45 years old comprised 18 females and 2 males. Frequencies of TgAb, pN1b, and local recurrence were higher in the DSV group than in the classical PTC group. Ten-year CSS and DFS rates for PTC patients <45 years old were 99.7 and 88.6 % in the classical PTC group and 100 and 60.5 % in the DSV group. CSS rate did not differ between groups, but DFS rate was significantly lower in the DSV group than in the classical PTC group (p < 0.0001, log-rank test). Multivariate analysis identified DSV group and pN1b as prognostic factors for recurrence in young PTC patients.

Conclusions

Most DSV patients were young and had a background of chronic thyroiditis. Outcomes for DSV were very good, but recurrence was more common than in classical PTC.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Vickery AL Jr, Carcangiu ML, Johannessen JV et al (1985) Papillary carcinoma. Sem Diagn Pathol 2:90–100

    Google Scholar 

  2. Hedinger C, Williams ED, Sobin LH (1989) The WHO histological classification of thyroid tumors: a commentary on the second edition. Cancer 63:908–911

    Article  CAS  PubMed  Google Scholar 

  3. Carcangiu ML, Bianchi S (1989) Diffuse sclerosing variant of papillary thyroid carcinoma. Clinicopathologic study of 15 cases. Am J Surg Pathol 13:1041–1049

    Article  CAS  PubMed  Google Scholar 

  4. Soares J, Limbert E, Sobrinho-Simoes M (1989) Diffuse sclerosing variant of papillary thyroid carcinoma. A clinicopathologic study of 10 cases. Pathol Res Pract 185:200–206

    Article  CAS  PubMed  Google Scholar 

  5. Wu PS, Leslie PJ, McLaren KM et al (1989) Diffuse sclerosing papillary carcinoma of thyroid: a wolf in sheep’s clothing. Clin Endocrinol (Oxf) 31:535–544

    Article  CAS  Google Scholar 

  6. Fujimoto Y, Obara T, Ito Y et al (1990) Diffuse sclerosing variant of papillary carcinoma of the thyroid. Clinical importance, surgical treatment, and follow-up study. Cancer 66:2306–2312

    Article  CAS  PubMed  Google Scholar 

  7. Hayashi Y, Sasao T, Takeichi N et al (1990) Diffuse sclerosing variant of papillary carcinoma of the thyroid. A histopathological study of four cases. Acta Pathol Jpn 40:193–198

    CAS  PubMed  Google Scholar 

  8. Mizukami Y, Nonomura A, Michigishi T et al (1990) Diffuse sclerosing variant of papillary carcinoma of the thyroid. Report of three cases. Acta Pathol Jpn 40:676–682

    CAS  PubMed  Google Scholar 

  9. Schroder S, Bay V, Dumke K et al (1990) Diffuse sclerosing variant of papillary thyroid carcinoma. S-100 protein immunocytochemistry and prognosis. Virchows Arch A Pathol Anat Histopathol 416:367–371

    Article  CAS  PubMed  Google Scholar 

  10. Gomez-Morales M, Alvaro T, Munoz M et al (1991) Diffuse sclerosing papillary carcinoma of the thyroid gland: immunohistochemical analysis of the local host immune response. Histopathology 18:427–433

    Article  CAS  PubMed  Google Scholar 

  11. Gomez-Morales M, Munoz M, Bustos M et al (1991) Diffuse sclerosing papillary carcinoma of the thyroid. Clin Endocrinol (Oxf) 34:432

    Article  CAS  Google Scholar 

  12. Macak J, Michal M (1993) Diffuse sclerosing variant of papillary thyroid carcinoma. Ceskoslov Patol 29:6–8

    CAS  Google Scholar 

  13. Moreno EA, Rodriguez GJM, Sola PJ et al (1994) Clinicopathological study of the diffuse sclerosing variety of papillary cancer of the thyroid. Presentation of 4 new cases and review of the literature. Eur J Surg Oncol 20:7–11

    Google Scholar 

  14. Caplan RH, Wester S (1997) Kisken AW Diffuse sclerosing variant of papillary thyroid carcinoma: case report and review of the literature. Endocr Pract 3:287–292

    Article  CAS  PubMed  Google Scholar 

  15. Albareda M, Puig-Domingo M, Wengrowicz S et al (1998) Clinical forms of presentation and evolution of diffuse sclerosing variant of papillary carcinoma and insular variant of follicular carcinoma of the thyroid. Thyroid 8:385–391

    Article  CAS  PubMed  Google Scholar 

  16. Khan AR, Abu-Eshy SA (1998) Variants of papillary carcinoma of the thyroid: experience at Asir Central Hospital. J R Coll Surg Edinb 43:20–25

    CAS  PubMed  Google Scholar 

  17. Imamura Y, Kasahara Y, Fukuda M (2000) Multiple brain metastases from a diffuse sclerosing variant of papillary carcinoma of the thyroid. Endocr Pathol 11:97–108

    Article  CAS  PubMed  Google Scholar 

  18. Kebapci N, Efe B, Kabukcuoglu S et al (2002) Diffuse sclerosing variant of papillary thyroid carcinoma with primary squamous cell carcinoma. J Endocrinol Invest 25:730–734

    Article  CAS  PubMed  Google Scholar 

  19. Chow SM, Chan JK, Law SC et al (2003) Diffuse sclerosing variant of papillary thyroid carcinoma–clinical features and outcome. Eur J Surg Oncol 29:446–449

    Article  PubMed  Google Scholar 

  20. Thompson LD, Wieneke JA (2005) Heffess CS Diffuse sclerosing variant of papillary thyroid carcinoma: a clinicopathologic and immunophenotypic analysis of 22 cases. Endocr Pathol 16:331–348

    Article  PubMed  Google Scholar 

  21. Falvo L, Giacomelli L, D’Andrea V et al (2006) Prognostic importance of sclerosing variant in papillary thyroid carcinoma. Am Surg 72:438–444

    PubMed  Google Scholar 

  22. Lam AK, Lo CY (2006) Diffuse sclerosing variant of papillary carcinoma of the thyroid: a 35-year comparative study at a single institution. Ann Surg Oncol 13:176–181

    Article  PubMed  Google Scholar 

  23. Fukushima M, Ito Y, Hirokawa M et al (2009) Clinicopathologic characteristics and prognosis of diffuse sclerosing variant of papillary thyroid carcinoma in Japan: an 18-year experience at a single institution. World J Surg 33:958–962. doi:10.1007/s00268-009-9940-6

    Article  PubMed  Google Scholar 

  24. Koo JS, Hong S (2009) Park CS Diffuse sclerosing variant is a major subtype of papillary thyroid carcinoma in the young. Thyroid 19:1225–1231

    Article  PubMed  Google Scholar 

  25. Koo JS, Shin E, Hong SW (2010) Immunohistochemical characteristics of diffuse sclerosing variant of papillary carcinoma: comparison with conventional papillary carcinoma. APMIS 118:744–752

    Article  PubMed  Google Scholar 

  26. Regalbuto C, Malandrino P, Tumminia A et al (2011) A diffuse sclerosing variant of papillary thyroid carcinoma: clinical and pathologic features and outcomes of 34 consecutive cases. Thyroid 21:383–389

    Article  PubMed  Google Scholar 

  27. Zimmerman D, Hay ID, Gough IR et al (1988) Papillary thyroid carcinoma in children and adults: long-term follow-up of 1039 patients conservatively treated at one institution during three decades. Surgery 104:1157–1166

    CAS  PubMed  Google Scholar 

  28. Lee JY, Shin JH, Han BK et al (2007) Diffuse sclerosing variant of papillary carcinoma of the thyroid: imaging and cytologic findings. Thyroid 17:567–573

    Article  CAS  PubMed  Google Scholar 

  29. Takami H, Ito Y, Okamoto T et al (2014) Revisiting the guidelines issued by the Japanese Society of thyroid surgeons and Japan Association of Endocrine Surgeons: a gradual move towards consensus between japanese and western practice in the management of thyroid carcinoma. World J Surg 38:2002–2010. doi:10.1007/s00268-014-2498-y

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

The authors have no conflict of interest to declare.

Author information

Authors and Affiliations

  1. Department of Surgery, Ito Hospital, 4-3-6, Jingumae, Shibuya-ku, Tokyo, 150-8308, Japan

    Junko Akaishi, Kiminori Sugino, Chie Masaki, Kenichi Matsuzu, Akifumi Suzuki, Takashi Uruno, Keiko Ohkuwa, Hiroshi Shibuya, Wataru Kitagawa, Mitsuji Nagahama & Koichi Ito

  2. Department of Pathology, Keio Hospital, 35, Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan

    Kaori Kameyama

  3. Department of Endocrine Surgery, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, Japan

    Kazuo Shimizu

Authors
  1. Junko Akaishi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kiminori Sugino
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kaori Kameyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Chie Masaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kenichi Matsuzu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Akifumi Suzuki
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Takashi Uruno
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Keiko Ohkuwa
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Hiroshi Shibuya
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Wataru Kitagawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Mitsuji Nagahama
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Kazuo Shimizu
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Koichi Ito
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Junko Akaishi.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Akaishi, J., Sugino, K., Kameyama, K. et al. Clinicopathologic Features and Outcomes in Patients with Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma. World J Surg 39, 1728–1735 (2015). https://doi.org/10.1007/s00268-015-3021-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-015-3021-9

Keywords

Search

Navigation