title: Early metastasizing spindle epithelial tumor with thymus-like differentiation (SETTLE) of the thyroid.
abstract: Spindle epithelial tumor with thymus-like elements is a rare thyroid lesion of children and young adults thought to be derived from branchial pouch remnants or foci of ectopic thymus. The lesion is poorly understood, and although it was originally believed to follow an indolent clinical course, its potential for late metastasis is becoming generally acknowledged. We have recently seen a unique case of this rare tumor in an 11-year-old boy, in which an unexpected and salient feature is the presence of a micrometastasis in a single lymph node at presentation. With the exception of 1 case with extensively infiltrative tumor and metastatic disease at the time of onset, in all other cases dissemination occurred years after surgical resection of the primary lesion. We review all previously reported cases and provide a detailed study of the histologic and ultrastructural appearances of this lesion.
authors.affiliation: Department of Pathology, Children's Yale-New Haven Hospital, Yale University School of Medicine, 430 Congress Avenue, New Haven, Connecticut 06525, USA.
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Erickson
authors.forename: Beatriz
authors.initials: B
authors.lastname: Tapia
authors.forename: Elsa R
authors.initials: ER
authors.lastname: Moreno
authors.forename: Milissa A
authors.initials: MA
authors.lastname: McKee
authors.forename: Diane P
authors.initials: DP
authors.lastname: Kowalski
authors.forename: Miguel
authors.initials: M
authors.lastname: Reyes-Múgica
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000032:analysis; D044963:Biopsy, Fine-Needle; D017024:Chemotherapy, Adjuvant; D002648:Child; D002945:Cisplatin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D006801:Humans; D007150:Immunohistochemistry; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D009375:Neoplasms, Glandular and Epithelial / Q000000981:diagnostic imaging / Q000556:secondary* / Q000628:therapy; D013950:Thymus Gland; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D013965:Thyroidectomy; D014057:Tomography, X-Ray Computed
chemical_list: D014408:Biomarkers, Tumor; D005047:Etoposide; D002945:Cisplatin