title: Warthin tumor-like papillary thyroid carcinoma with a minor dedifferentiated component: report of a case with clinicopathologic considerations.
abstract: Warthin tumor-like papillary thyroid carcinoma is an uncommon variant of papillary thyroid carcinoma. We report a rare case of Warthin tumor-like variant of papillary thyroid carcinoma with a dedifferentiated component consisting of a solid tumor area composed of neoplastic cells with a spindle to tall cell morphology associated with marked nuclear pleomorphism, atypical mitoses, and foci of necrosis. Although our patient presented with a locally aggressive disease (T3 N1b Mo), she is disease-free without radioiodine therapy after a 23-month follow-up period. We emphasize that Warthin tumor-like papillary thyroid carcinoma, like other morphological variants of papillary carcinoma, may occasionally undergo dedifferentiation. As this component may be only focally detectable, we suggest an extensive sampling of all large-sized (>3 cm) papillary thyroid carcinoma. Recognition of any dedifferentiated component in a Warthin tumor-like papillary thyroid carcinoma should be reported, including its percentage, because it may reflect a more aggressive clinical course.
authors.affiliation: Section of Anatomic Pathology, Department G.F. Ingrassia, University of Catania, 95123 Catania, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Amico
authors.forename: Salvatore
authors.initials: S
authors.lastname: Lanzafame
authors.forename: Giovanni
authors.initials: G
authors.lastname: Li Destri
authors.forename: Paolo
authors.initials: P
authors.lastname: Greco
authors.forename: Rosario
authors.initials: R
authors.lastname: Caltabiano
authors.forename: Giada Maria
authors.initials: GM
authors.lastname: Vecchio
authors.forename: Gaetano
authors.initials: G
authors.lastname: Magro