J Korean Soc Endocrinol.  2005 Feb;20(1):84-89. 10.3803/jkes.2005.20.1.84.

A Case of Primary Squamous Cell Carcinoma of the Thyroid Gland

• Bae KI
• Kim KH
• Yang SY
• Lee SH
• Kwon SK
• Jung SJ

• KMID: 2100457
• DOI: http://doi.org/10.3803/jkes.2005.20.1.84

Abstract

Primary squamous cell carcinoma of the thyroid gland is an extremely rare case to observe and represents less than 1% in all the primary thyroid malignancies. Normally, squamous epithelium is absent in the thyroid gland and presently; its origin is believed to arise from metaplasia of follicular epithelium. Cancer has very aggressive clinical behavior and a very poor prognosis with survival rates of less than 1 year. The best chances of survival have been achieved with complete resection followed by postoperative radiotherapy. Recently, we came across a case of 80-year-old woman with primary squamous cell cacinoma of the thyroid gland present in the background of Hashimoto's thyroiditis. The patient had swelling in the anterior neck portion from the past 20 days. On physical examinaton, 3x3cm2 hard and fixed ill defined mass was detected in the right lobe of thyroid. Repeated fine needle aspiration biopsy of the thyroid revealed the presence of carcinoma. Apparently, Palliative thyroidectomy was performed after 3 months of diagnosis. During operation, the tumor was revealed as a mass of 100mm in diameter and infiltrated the surrounding muscles, trachea and other soft tissue in the neck. After the operation, the patient's condition deteriorated and ultimately after 5 months of her initial visit, she died due to respiratory failure.

MeSH Terms

Aged, 80 and over
Biopsy
Biopsy, Fine-Needle
Carcinoma, Squamous Cell*
Diagnosis
Epithelium
Female
Humans
Metaplasia
Muscles
Neck
Prognosis
Radiotherapy
Respiratory Insufficiency
Survival Rate
Thyroid Gland*
Thyroidectomy
Thyroiditis
Trachea

Figure

• 

  Fig. 1 Thyroid Ultrasonography. It shows a mass with central necrosis and calcification in right lobe of thyroid gland.

• 

  Fig. 2 Neck computerized tomography. It shows diffuse thyroid enlargement and right lobe mass (3.4×2.4 cm) with central degeneration and calcification. Extracapsular invasion to strap muscle is noted.

• 

  Fig. 3 Microscopic finding:needle biopsy. Irregular clusters of tumor cells in dense fibrotic stroma are noted. which show polygonal and elongated appearance with occasional nuclear inclusions (Inlet) (H&E, ×40, inlet : ×400)

• 

  Fig. 4a The tumor cells show indistinct but suspicious desmosomes with keratin formation in cytoplasm (H&E, ×200)

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  Fig. 4b Infiltrating tumor cells are arranged in irregular sheets or trabeculae with some lymphoplasma cells in the dense fibrous septae (H&E, ×40)

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