Papillary carcinoma of the thyroid gland forming a myofibroblastic nodular tumor: report of two cases and review of the literature.
We encountered two unique cases of papillary carcinoma of the thyroid gland forming fibroma-like nodular tumors. The two cases showed well-defined nodules composed largely of fibromatosis-like stroma with small foci of papillary carcinoma. This type of tumor is relatively rare and has been reported with the name of 'papillary carcinoma of the thyroid with fibromatosis-like stroma or nodular fasciitis-like stroma'. The stromal cells have had myofibroblastic features in all reported cases, including the present cases. The pathogenesis of this tumor is still unknown. We must be careful to differentiate this type of thyroid tumor from fibrosarcomatous anaplastic carcinoma, particularly in the intraoperative consultation. We speculate that this unique tumor is an autonomous proliferation of stromal cells, based on the immunohistochemical analyses of early stromal changes in usual-type papillary carcinoma of the thyroid. The present names of this disease may not represent the proper features of this tumor because all the reported cases formed fibroma-like nodules. We propose the name 'papillary carcinoma forming myofibroblastic nodular tumors'.
Naganuma
Hiroshi
H
Department of Pathology, Sendai City Hospital, Sendai, Miyagi, Japan. hnaganuma@rio.odn.ne.jp
Iwama
Noriyuki
N
Nakamura
Yasuyuki
Y
Ohtani
Noriko
N
Ohtani
Haruo
H
Takaya
Kiyoshi
K
Sakai
Nobumitsu
N
D030201:Activin Receptors, Type I / Q000032:analysis; D000328:Adult; D002291:Carcinoma, Papillary / Q000378:metabolism / Q000473:pathology*; D003937:Diagnosis, Differential; D005350:Fibroma / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D017346:Protein Serine-Threonine Kinases; D020796:Receptor, Platelet-Derived Growth Factor alpha / Q000032:analysis; D020797:Receptor, Platelet-Derived Growth Factor beta / Q000032:analysis; D000077293:Receptor, Transforming Growth Factor-beta Type I; D000077294:Receptor, Transforming Growth Factor-beta Type II; D018125:Receptors, Transforming Growth Factor beta / Q000032:analysis; D013964:Thyroid Neoplasms / Q000378:metabolism / Q000473:pathology*; D016212:Transforming Growth Factor beta / Q000032:analysis
D018125:Receptors, Transforming Growth Factor beta; D016212:Transforming Growth Factor beta; D020796:Receptor, Platelet-Derived Growth Factor alpha; D020797:Receptor, Platelet-Derived Growth Factor beta; D017346:Protein Serine-Threonine Kinases; D030201:Activin Receptors, Type I; D000077293:Receptor, Transforming Growth Factor-beta Type I; D000077294:Receptor, Transforming Growth Factor-beta Type II