Korean J Endocr Surg.  2014 Mar;14(1):22-26.

Hyalinizing Trabecular Tumor (HTT) of Thyroid: Two Case Report

• Ma MS
• Jung EJ
• Kim JY
• Choi SK
• Hong SC
• Lee YJ
• Joo YT
• Jeong CY
• Jeong SH
• Park TJ
• Kwak SJ
• Park JH
• Lee JH

Abstract

Hyalinizing trabecular tumor (HTT), a type of thyroid lesion, was first reported by Carney in 1987 and has since been reported continuously. Due to its histological non-specificity, HTT can be misdiagnosed as papillary thyroid cancer or medullary thyroid cancer. For this reason, over treatment might occur; for example, total thyroidectomy and lymphadenectomy. Diagnosis and treatment is a challenge because there is still controversy regarding HTT characters. We report on two cases. One patient was a 48-year-old female and the other was a 46-year-old female. Both patients complained of a thyroid mass and were diagnosed as HTT.

Keyword

Hyalinizing trabecular tumor; Papillary thyroid cancer; Medullary thyroid cancer; Differential diagnosis

MeSH Terms

Diagnosis
Diagnosis, Differential
Female
Humans
Hyalin*
Lymph Node Excision
Middle Aged
Thyroid Gland*
Thyroid Neoplasms
Thyroidectomy

Figure

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  Fig. 1. Case 1. Ultrasonography feature of 48-year-old women. Transverse and longitudinal sonogram shows a 2.8 cm solid, cystic and heterogeneous mass in right lobe of thyroid (A). Transverse and longitudinal sonogram show a 1.7 cm solid, cystic and well defined heterogeneous mass in left lobe of thyroid, Fine needle aspiration was done two mass.

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  Fig. 2. On frozen section show the cluster of tumor cells reveal nuclear overlapping and nuclear inclusion (arrow), which can be misinterpreted as papillary carcinoma (H&E stain, ×100 (A), ×400 (B)).

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  Fig. 3. The Ki-67 staining characteristic membranous staining. The endothelial cell or inflammatory cell show usual nuclear staining pattern (arrow). ×400 (A, B).

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  Fig. 4. Case 2. Ultrasonography feature of 48-year-old women. Transverse and longitudinal sonogram show a 1 cm solid, heterogeneous and intermediate mass, a 0.7 cm irregular hypoechoic mass which suggested malignant lesion in right lobe of thyroid. (A) Transverse and longitudinal sonogram show a 0.9 cm heterogeneous hypoechoic mass in left lobe of thyroid. (B) Fine needle aspiration was done right 0.7 cm, left 0.9 cm mass.

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  Fig. 5. Histology of 0.7 cm HTT. Polygonal, oval, spindle shape and trabecular arrangement of cells with hyaline material deposit (H&E stain, ×200).

Reference

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