Int J Thyroidol.  2017 Nov;10(2):107-113. 10.11106/ijt.2017.10.2.107.

Primary Sclerosing Mucoepidermoid Carcinoma with Eosinophilia of the Thyroid: Description of a Case and Review of the Literature

Affiliations
  • 1Department of Surgery, Kosin University College of Medicine, Busan, Korea. tonybin@daum.net
  • 2Department of Surgery, Hub-Hu Hospital, Busan, Korea.

Abstract

Primary sclerosing mucoepidermoid carcinoma with eosinophilia (SMECE) of the thyroid gland is a very rare disease. We present the clinical and histopathologic findings of a 37-year-old woman recently diagnosed with SMECE of the thyroid gland. The patient, clinically euthyroid, who presented with a neck swelling since last 2 years along. Fine needle aspiration cytology suggested thyroid papillary carcinoma. Total thyroidectomy, central neck dissection and right selective neck dissection were performed. Although SMECE is considered to be a relatively slow growing and non-aggressive tumor, occasional metastasis does occur. We report an additional case of SMECE, with metastasis to regional lymph nodes. Physicians should be aware of extended operation, including total thyroidectomy and/or neck node dissection for metastatic lesion of the neck node. More standardized treatment is likely to evolve in the future.

Keyword

Mucoepidermoid; Carcinoma; Eosinophilia; Thyroid gland

MeSH Terms

Adult
Biopsy, Fine-Needle
Carcinoma, Mucoepidermoid*
Carcinoma, Papillary
Eosinophilia*
Female
Humans
Lymph Nodes
Neck
Neck Dissection
Neoplasm Metastasis
Rare Diseases
Thyroid Gland*
Thyroidectomy

Figure

  • Fig. 1. Neck computed tomography with contrast enhance-ment demonstrating tumor invasion of the right thyroid lobe. A right supraclavicular lymph node metastasis is present (arrow).

  • Fig. 2. 18F-fludeoxyglucose (FDG) positron emission tomography (PET) scan shows a metastatic lymphadenopathy at right supraclavicular area (arrow).

  • Fig. 3. The tumor nodule has ill-defined border and adjacent thyroid reveals lymphocytic thyroiditis (H&E staining, ×40).

  • Fig. 4. The tumor is characterized by anastomosing compact cords and nests of epidermoid cells, accompanied by extensive sclerosis and by infiltration of eosinophils, lymphocytes and plasma cells (A: H&E staining, ×100; B: inlet, ×400).

  • Fig. 5. (A) Tumor contains a well-formed squamous pearl. (B) Mucocytes compressed by globules of mucin is interspersed in epidermoid cells (H&E staining, ×400).


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