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Prognostic factors of clinical interest in poorly differentiated carcinomas of the thyroid

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Abstract

Poorly differentiated (PD) carcinomas of the thyroid represent an heterogeneous but distinct group of tumors, clinically and histopathogenetically intermediate between follicular-derived well-differentiated and anaplastic carcinomas. Although the diagnostic criteria for inclusion in the PD tumor group are far from well established, and despite controversies on nomenclature, the identification of PD carcinomas as tumors with trabecular/insular/solid (TIS) growth patterns and high-grade histopathological parameters is generally accepted. Recent data on large tumor series were focused on the recognition of clinicopathological features able to predict aggressive behavior. Patient age >45 yr, the presence of necrosis (either focal or extensive), and mitotic count > 3 per 10 HPF have been found to be the most influent prognostic parameters. Therefore, as also proposed for other thyroid carcinomas (e.g., papillary carcinoma) grading of PD carcinomas on the basis of these latter parameters is encouraged to select those cases with a high risk of poor outcome.

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References

  1. Sakamoto A, Kasai N, Sugano H. Poorly differentiated carcinoma of the thyroid. A clinicopathologic entity for a high-risk group of papillary and follicular carcinomas. Cancer 52:1849–1855, 1983.

    Article  PubMed  CAS  Google Scholar 

  2. Cabanne F, Gerard-Marchant R, Heimann R, Williams ED. Tumeurs malignes du corps thyroide. Problèmes de diagnostic histopathologique. A propos de 692 lèsions recuilles par le groupe coopèrateur de l’O.E.R.T.C. Ann Anat Pathol 19:129–148, 1974.

    CAS  Google Scholar 

  3. Carcangiu ML, Zampi G, Rosai J. Poorly differentiated («insular») thyroid carcinoma. Am J Surg Pathol 8:655–668, 1984.

    Article  PubMed  CAS  Google Scholar 

  4. Pilotti S, Collini P, Mariani L, et al. Insular carcinoma: a distinct de novo entity among follicular carcinomas of the thyroid gland. Am J Surg Pathol 21:1466–1473, 1997.

    Article  PubMed  CAS  Google Scholar 

  5. Sobrinho-Simoes M, Sambade C, Fonseca E, Soares P. Poorly differentiated carcinomas of the thyroid gland: a review of the clinicopathologic features of a series of 28 cases of a heterogeneous, clinically aggressive group of thyroid tumors. Int J Surg Pathol 10:123–131. 2002.

    PubMed  Google Scholar 

  6. Nishida T, Katayama S, Tsujimoto M, Nakamura J, Matsuda H. Clinicopathological significance of poorly differentiated thyroid carcinoma. Am J Surg Pathol 23:205–211, 1999.

    Article  PubMed  CAS  Google Scholar 

  7. Ljungberg O, Bondeson L, Bondeson AG. Differentiated thyroid carcinoma, intermediate type: a new tumor entity with features of follicular and parafollicular cell carcinoma. Hum Pathol 15:218–228, 1984.

    Article  PubMed  CAS  Google Scholar 

  8. Papotti M, Botto Micca F, Favero A, Palestini N, Bussolati G. Poorly differentiated thyroid carcinomas with primordial cell component. A group of aggressive lesions sharing insular, trabecular, and solid patterns. Am J Surg Pathol 17:291–301, 1993.

    Article  PubMed  CAS  Google Scholar 

  9. Byar DP, Green SB, Dor P, et al. A prognostic index for thyroid carcinoma. A study of the E.O.R.T.C. Thyroid Cancer Cooperative Group. Eur J Cancer 15:1033–1041, 1979.

    PubMed  CAS  Google Scholar 

  10. Ashfaq R, Vuitch F, Delgado R, Albores-Saavedra J. Papillary and follicular thyroid carcinomas with an insular component. Cancer 73:416–423, 1994.

    Article  PubMed  CAS  Google Scholar 

  11. Sobrinho-Simões M. Poorly differentiated thyroid carcinomas. Endocr Pathol 2:99–102, 1996.

    Google Scholar 

  12. Akslen LA, LiVolsi VA. Poorly differentiated thyroid carcinoma—it is important. Am J Surg Pathol 24:310–313, 2000.

    Article  PubMed  CAS  Google Scholar 

  13. Nishiyama RH. Another dissertation on poorly differentiated carcinomas: is it really necessary? Adv Anat Pathol 6:281–286, 1999.

    Article  PubMed  CAS  Google Scholar 

  14. Pilotti S, Collini P, Manzari A, Marubini E, Rilke F. Poorly differentiated forms of papillary thyroid carcinoma: distinctive entities or morphological patterns? Semin Diagn Pathol 12:249–255, 1995.

    PubMed  CAS  Google Scholar 

  15. Tallini G, Garcia-Rostan G, Herrero A, et al. Downregulation of p27KIP1 and Ki67/Mib1 labeling index support the classification of thyroid carcinoma into prognostically relevant categories. Am J Surg Pathol 23:678–685, 1999.

    Article  PubMed  CAS  Google Scholar 

  16. Mizukami Y, Noguchi M, Michigishi T, et al. Papillary thyroid carcinoma in Kanazawa, Japan: prognostic significance of histological subtypes. Histopathology 20:243–250, 1992.

    Article  PubMed  CAS  Google Scholar 

  17. Nikiforov YE, Erickson LA, Nikiforova MN, Caudill CM, Lloyd RV. Solid variant of papillary thyroid carcinoma: incidence, clinicalpathologic characteristics, molecular analysis, and biologic behavior. Am J Surg Pathol 25:1478–1484, 2001.

    Article  PubMed  CAS  Google Scholar 

  18. Santoro M, Papotti M, Chiappetta G, et al. RET activation and clinicopathologic features in poorly differentiated thyroid tumors. J Clin Endocrinol Metab 87:370–379, 2002.

    Article  PubMed  CAS  Google Scholar 

  19. Nikiforova MN, Kimura ET, Gandhi M, et al. BRAF mutations in thyroid tumors are restricted to papillary carcinomas and anaplastic or poorly differentiated carcinomas arising from papillary carcinomas. J Clin Endocrinol Metab 88:5399–5404, 2003.

    Article  PubMed  CAS  Google Scholar 

  20. Papotti M, Torchio B, Grassi L, Favero A, Bussolati G. Poorly differentiated oxyphilic (Hürthle cell) carcinomas of the thyroid. Am J Surg Pathol 20:686–694, 1996.

    Article  PubMed  CAS  Google Scholar 

  21. Evans HL, Vassilopoulou-Sellin R. Follicular and Hürthle cell carcinomas of the thyroid: a comparative study. Am J Surg Pathol 22:1512–1520, 1998.

    Article  PubMed  CAS  Google Scholar 

  22. Heffess CS, Thompson LDR. Minimally invasive follicular thyroid carcinoma. Endocr Pathol 12:417–422, 2001.

    Article  PubMed  CAS  Google Scholar 

  23. Decaussin M, Bernard MH, Adeleine P, et al. Thyroid carcinomas with distant metastases: a review of 111 cases with emphasis on the prognostic significance of an insular component. Am J Surg Pathol 26:1007–1015, 2002.

    Article  PubMed  Google Scholar 

  24. Akslen LA, LiVolsi VA. Prognostic significance of histologic grading compared with subclassification of papillary thyroid carcinoma. Cancer 88:1902–1908, 2000.

    Article  PubMed  CAS  Google Scholar 

  25. Volante M, Landolfi S, Chiusa L, et al. Poorly differentiated carcinomas of the thyroid with trabecular, insular and solid patterns. A clinicopathological study of 183 cases. Cancer 100:950–957, 2004.

    Article  PubMed  Google Scholar 

  26. Rosai J, Carcangiu ML, De Lellis RA. Tumors of the thyroid gland. In: Atlas of tumor pathology. Washington: Armed Forces Institute of Pathology, 1992; pp. 161–182.

    Google Scholar 

  27. Pellegriti G, Giuffrida D, Scollo C, et al. Long-term outcome of patients with insular carcinoma of the thyroid: the insular histotype is an independent predictor of poor prognosis. Cancer 95:2076–2085, 2002.

    Article  PubMed  Google Scholar 

  28. Sasaki A, Daa T, Kashima K, Yokoyama S, Nakayama I, Noguchi S. Insular component as a risk factor of thyroid carcinoma. Pathol Int 46:939–946, 1996.

    Article  PubMed  CAS  Google Scholar 

  29. LiVolsi VA, Baloch ZW. Predicting prognosis in thyroid carcinoma: can histology do it? Am J Surg Pathol 26:1064–1065, 2002.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Biomedical Sciences & Human Oncology, Turin

    Marco Volante MD

  2. Department of Clinical Physiopathology, Turin

    Gianni P. Cavallo MD

  3. Department of Clinical and Biological Sciences, University of Turin, San Luigi Hospital, Regione Gonzole 10, 10034, Orbassano, Italy

    Mauro Papotti MD

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  1. Marco Volante MD
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  2. Gianni P. Cavallo MD
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  3. Mauro Papotti MD
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Correspondence to Mauro Papotti MD.

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Volante, M., Cavallo, G.P. & Papotti, M. Prognostic factors of clinical interest in poorly differentiated carcinomas of the thyroid. Endocr Pathol 15, 313–317 (2004). https://doi.org/10.1385/EP:15:4:313

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