Document Type : Case Reports
Department of Otolaryngology-Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Department of Pathology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Department of Otolaryngology- Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Papillary thyroid carcinoma (PTC) is considered as a relatively common type of malignancy showing a wide morphologic spectrum. Different variants of this tumor have been reported. Among PTC variants, PTC with nodular fasciitis-like stroma (PTC‑FLS) is rare. This variant consists of stromal components rich in spindle cells and accounts for 60-80% of tumors. In addition, there are small foci of epithelial components in PTC‑FLS though its features are similar to conventional PTC. In this case study, we present a new case with PTC‑FLS. The case is a 28-year-old female who was referred to the ENT clinic due to a painless mass on the anterior part of her neck. The mass showed a gradual increase in size over the 6 months prior to her referral. Thyroid test results were normal. Ultrasound imaging demonstrated an 84 × 36 mm heterogeneous nodule in the right thyroid lobe without calcifications but increased vascularity. There were also some reactive lymph nodes in both sub-mandibular areas. An ultrasound-guided fine-needle aspiration (FNA) biopsy of the right thyroid lobe nodule revealed a benign thyroid adenomatoid nodule. Following right thyroid lobectomy, final pathologic studies confirmed a diagnosis of PTC with exuberant fibromatosis-like stroma. In the 20-day post-surgery visit, the patient was found asymptomatic. Re-evaluation of the left thyroid lobe and follow-up were recommended. In this study, a diagnosis of a rare variant of PTC, i.e., PTC-FLS, was made through a combination of ultrasonography, fine needle aspiration cytology, and histological examination.
- Wu Z, Chu X, Fan S, Meng X, Xu C. Papillary thyroid carcinoma with fibromatosis-like stroma: A case report and review of the literature. Oncol Lett. 2013;5(1):215-7. [DOI:10.3892/ol.2012.993] [PMID] [PMCID]
- Zhou L, Shi L, Jiang Z, Xie L. Papillary thyroid carcinoma with nodular fasciitis-like stroma and beta-catenin gene mutations: report of a recurrent case. Int J Clin Exp Pathol. 2018;11(5):2879-83.
- Pepe P, Panella P, Pennisi M, Aragona F. Does color Doppler sonography improve the clinical assessment of patients with acute scrotum? Eur J Radiol. 2006;60(1):120-4. [DOI:10.1016/j.ejrad.2006.04.016] [PMID]
- Na KY, Kim HS, Sung JY, Park WS, Kim YW. Papillary Carcinoma of the Thyroid Gland with Nodular Fasciitis-like Stroma. Korean J Pathol. 2013;47(2):167-71. [DOI:10.4132/KoreanJPathol.2013.47.2.167] [PMID] [PMCID]
- Siegel NS, Bradford CR. Fibromatosis of the head and neck: a challenging lesion. Otolaryngol Head Neck Surg. 2000;123(3):269-75. [DOI:10.1067/mhn.2000.107456] [PMID]
- Kiel KD, Suit HD. Radiation therapy in the treatment of aggressive fibromatoses (desmoid tumors). Cancer. 1984;54(10):2051-5. [DOI:10.1002/1097-0142(19841115)54:103.0.CO;2-2]
- Clark SK, Phillips RK. Desmoids in familial adenomatous polyposis. Br J Surg. 1996;83(11):1494-504. [DOI:10.1002/bjs.1800831105] [PMID]
- Lee K-H, Lee J-S, Choi C, Yoon J-H, Chung J-H, Min K-W. Thyroid Papillary Carcinoma with Exuberant Nodular Fasciitis-like Stroma-A Case Report. Korean J Pathol. 2006;40(1):76-9.
- Lee Y-S, Hong S-W, Yoon J-S, Jeong J-J, Nam K-H, Chung W-Y, et al. Papillary thyroid carcinoma with nodular fasciitis-like stroma. Ann Surg Treat Res. 2007;73(6):502-6.
- Lee KW, Park WC, Kim JY, Lee YS, Kim MK. Sonographic finding of papillary thyroid carcinoma with nodular fasciitis-like stroma. J Med Ultrason (2001). 2010;37(2):59-61. [DOI:10.1007/s10396-009-0255-x] [PMID]
- Ballo MT, Zagars GK, Pollack A, Pisters PW, Pollack RA. Desmoid tumor: prognostic factors and outcome after surgery, radiation therapy, or combined surgery and radiation therapy. J Clin Oncol. 1999;17(1):158-67. [DOI:10.1200/JCO.19126.96.36.199] [PMID]