axillary node metastasis from differentiated thyroid carcinoma with hürthle and signet ring cell differentiation. a case of disseminated thyroid cancer with peculiar histologic findings腋窝淋巴结转移与许特耳氏和印戒细胞分化甲状腺癌分化。.pdfVIP

Chiofalo et al. BMC Cancer 2012, 12:55 /1471-2407/12/55 CASE REPORT Open Access Axillary node metastasis from differentiated thyroid carcinoma with hürthle and signet ring cell differentiation. A case of disseminated thyroid cancer with peculiar histologic findings 1 2 2 3 4 Maria Grazia Chiofalo , Nunzia Simona Losito , Franco Fulciniti , Sergio Venanzio Setola , Antonio Tommaselli , Ugo Marone5, Maria Luisa Di Cecilia5 and Luciano Pezzullo1* Abstract Background: Differentiated thyroid cancer is usually associated with an excellent prognosis and indolent course. Distant metastases are rare events at the onset of thyroid cancer. Among these presentations, metastasis to the axillary lymph nodes is even more unusual: only few cases were previously reported in the literature; there has been no report of axillary lymph node metastasis from follicular thyroid carcinoma. Axillary lymph node metastasis generally arises in the context of disseminated disease and carries an ominous prognosis. Case presentation: Here we present a case of axillary lymph node metastasis in the context of disseminated differentiated thyroid cancer. The patient underwent near total thyroidectomy and neck and axillary lymph node dissection. A histopathological diagnosis of poorly differentiated follicular carcinoma with “signet ring cells” and Hürthle cell features was established. The patient received radioactive iodine therapy and TSH suppression therapy. Subsequently his serum thyroglobulin level decreased to 44.000 ng/ml from over 100.000 ng/ml. Discussion and Conclusion: Currently there are only few reported cases of axillary node metastases from thyroid cancer, and to our knowledge, this is the first report on a