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Asynchronous cutaneous metastases of medullary thyroid carcinoma.

Ghanadan A - South Asian J Cancer (2015 Apr-Jun)

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatopathology, Razi Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

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Dear Editor, Thyroid cancer as the most common endocrine malignancy usually appears as primary nodules within the gland but less frequently presents with other features such as metastases, which truly impoverishes the prognosis of the patient... Cutaneous metastasis of MTC usually occurs in the late stage of malignancy and average length of survival after diagnosis of cutaneous metastasis is very low... Immunoreaction to TTF-1 is helpful to distinguish metastatic lung and thyroid carcinoma from metastatic gastrointestinal carcinoma and mesothelioma which are negative... Mesothelioma is ruled out by negative reaction to calretinin... Immunoreactivity to thyroglobulin can exclude lung carcinoma and differentiate papillary and follicular carcinoma of thyroid from MTC which is negative... Precise diagnosis of MTC is upon positive reactivity to calcitonin and neuroendocrine markers, including chromogranin, synaptophysin, and CD56... This asynchronous metastasis of MTC to skin is extremely rare presenting in the late stage of a disseminated malignancy... Cutaneous metastasis of MTC should be considered in any patients with flesh-colored skin nodule in upper part of the trunk... Histologically, it should be distinguished from primary skin tumors and metastasis of lung and gastrointestinal carcinoma as well as mesothelioma by the aid of immunohistochemistry staining.

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Related in: MedlinePlus

(a) Thyroid transcription factor-1 staining shows nuclear immunoreactivity of tumor cells (immunohistochemical staining, original magnification ×20). (b) Positive immunoreactivity of tumor cells with calcitonin (immunohistochemical staining, original magnification ×20)
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Figure 2: (a) Thyroid transcription factor-1 staining shows nuclear immunoreactivity of tumor cells (immunohistochemical staining, original magnification ×20). (b) Positive immunoreactivity of tumor cells with calcitonin (immunohistochemical staining, original magnification ×20)

Mentions: Histopathologic examination revealed a well-circumscribed tumor in dermis composed of delicate trabecules, cohesive sheets and nests consisting of small to medium-sized cells with ovoid nuclei, prominent nucleoli, and pale to eosinophilic cytoplasm [Figure 1]. Histopathologic findings were in favor of poorly-differentiated carcinoma. Immunohistochemistry shows positive reactivity to chromogranin, synaptophysin, CD56, carcinoembryonic antigen, and S-100 which is suggestive of neuroendocrine carcinoma. Positive reaction to thyroid transcription factor (TTF)-1 and calcitonin and no reaction with thyroglobulin were consistent with metastatic MTC [Figure 2a and 2b]. Melanoma, merkel cell carcinoma, and mesothelioma were ruled out by negative reaction to HMB-45, CD20, and calretinin, respectively.


Asynchronous cutaneous metastases of medullary thyroid carcinoma.

Ghanadan A - South Asian J Cancer (2015 Apr-Jun)

(a) Thyroid transcription factor-1 staining shows nuclear immunoreactivity of tumor cells (immunohistochemical staining, original magnification ×20). (b) Positive immunoreactivity of tumor cells with calcitonin (immunohistochemical staining, original magnification ×20)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4418078&req=5

Figure 2: (a) Thyroid transcription factor-1 staining shows nuclear immunoreactivity of tumor cells (immunohistochemical staining, original magnification ×20). (b) Positive immunoreactivity of tumor cells with calcitonin (immunohistochemical staining, original magnification ×20)
Mentions: Histopathologic examination revealed a well-circumscribed tumor in dermis composed of delicate trabecules, cohesive sheets and nests consisting of small to medium-sized cells with ovoid nuclei, prominent nucleoli, and pale to eosinophilic cytoplasm [Figure 1]. Histopathologic findings were in favor of poorly-differentiated carcinoma. Immunohistochemistry shows positive reactivity to chromogranin, synaptophysin, CD56, carcinoembryonic antigen, and S-100 which is suggestive of neuroendocrine carcinoma. Positive reaction to thyroid transcription factor (TTF)-1 and calcitonin and no reaction with thyroglobulin were consistent with metastatic MTC [Figure 2a and 2b]. Melanoma, merkel cell carcinoma, and mesothelioma were ruled out by negative reaction to HMB-45, CD20, and calretinin, respectively.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatopathology, Razi Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Dear Editor, Thyroid cancer as the most common endocrine malignancy usually appears as primary nodules within the gland but less frequently presents with other features such as metastases, which truly impoverishes the prognosis of the patient... Cutaneous metastasis of MTC usually occurs in the late stage of malignancy and average length of survival after diagnosis of cutaneous metastasis is very low... Immunoreaction to TTF-1 is helpful to distinguish metastatic lung and thyroid carcinoma from metastatic gastrointestinal carcinoma and mesothelioma which are negative... Mesothelioma is ruled out by negative reaction to calretinin... Immunoreactivity to thyroglobulin can exclude lung carcinoma and differentiate papillary and follicular carcinoma of thyroid from MTC which is negative... Precise diagnosis of MTC is upon positive reactivity to calcitonin and neuroendocrine markers, including chromogranin, synaptophysin, and CD56... This asynchronous metastasis of MTC to skin is extremely rare presenting in the late stage of a disseminated malignancy... Cutaneous metastasis of MTC should be considered in any patients with flesh-colored skin nodule in upper part of the trunk... Histologically, it should be distinguished from primary skin tumors and metastasis of lung and gastrointestinal carcinoma as well as mesothelioma by the aid of immunohistochemistry staining.

No MeSH data available.


Related in: MedlinePlus