title: [Mixed medullary and follicular carcinoma of the thyroid: report of one case].
abstract: BACKGROUND
  Mixed medullary-follicular carcinoma of the thyroid with pleomorphic pattern is an uncommon malignant epithelial tumor characterized by clinical and immunohistochemical features of both follicular and parafollicular thyroidal C cells.
  
  
  METHODS
  We describe a rare case of this type of tumor observed in a 56 year old woman, undergone total thyroidectomy for suspected thyroid carcinoma, without lymph node metastasis. Preoperative basal calcitonin levels were in the limits, while thyroglobulin resulted increased. Presence of the latter suggests a potential usefulness of radioiodine therapy as an additional therapeutic tool for this type of tumor.
  
  
  RESULTS
  Histological and immunohistochemical findings were surprising showing characteristic patterns and thyroglobulin and calcitonin positivity. After postoperative diagnosis the patient undergone specific endocrine and scintigraphic tests.
  
  
  CONCLUSIONS
  Early diagnosis of a mixed medullary-follicular thyroid carcinoma is essential, considering its special therapy and negative prognosis. In fact it constitutes another clinicopathologic entity, different from typical medullary thyroid carcinoma and it's associated with a more favourable clinical course than the former. A precise diagnosis of this uncommon variety of medullary carcinoma of the thyroid is fundamental for an accurate treatment of the patient, but also for familiar genetic screening excluding MEN II syndromes. A radical surgical therapy plays a key-role for the treatment and the follow-up of this rare tumoral entity.
authors.affiliation: Dipartimento per le Applicazioni in Chirurgia delle Tecnologie Innovative, Sezione di Chirurgia Generale e Chirurgia Toracica, Università degli Studi di Bari.
authors.forename: E
authors.initials: E
authors.lastname: Giove
authors.forename: G
authors.initials: G
authors.lastname: Renzulli
authors.forename: C
authors.initials: C
authors.lastname: Lorusso
authors.forename: D
authors.initials: D
authors.lastname: Merlicco
authors.forename: D
authors.initials: D
authors.lastname: Iacobone
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000473:pathology*; D018276:Carcinoma, Medullary / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000473:pathology*; D013964:Thyroid Neoplasms / Q000473:pathology*
vernacular_title: Carcinoma misto midollare e follicolare della tiroide: case report.