Diffuse sclerosing variant of papillary thyroid carcinoma with multiple metastases and elevated serum carcinoembryonic antigen level.
BACKGROUND
Diffuse sclerosing variant of papillary thyroid carcinoma (DSPC) is a rare variant of papillary thyroid carcinoma (PTC). We report a 61-year-old female of DSPC whose course was complicated by multiple metastases and an elevated serum carcinoembryonic antigen (CEA) level.


CONCLUSIONS
The patient presented with upper back pain. X-ray showed an osteolytic lesion of the sixth cervical spinous process. She had a hard, nonmovable mass with fixed enlarged lymph nodes (LNs) over right neck. Fine-needle aspiration cytology revealed PTC with LNs metastasis. Positron emission tomography demonstrated multiple brain, bone, liver, and lung metastases. However, the patient had an elevated serum CEA level. She underwent a total thyroidectomy and 200 mCi radioactive (131)I therapy. The pathological findings were diffuse sclerosing variant of PTC with capsular and lymph vessel invasion. A double staining of tumor specimen appeared concomitantly positive for CEA and thyroglobulin.


CONCLUSIONS
To our knowledge, DSPC with an elevated CEA level is extremely rare.
Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Chin-Sung
CS
Kuo
Kam-Tsun
KT
Tang
Jiun-Dian
JD
Lin
An-Hang
AH
Yang
Chen-Hsen
CH
Lee
Hong-Da
HD
Lin
D002272:Carcinoembryonic Antigen / Q000097:blood*; D002277:Carcinoma / Q000473:pathology* / Q000532:radiotherapy; D002291:Carcinoma, Papillary / Q000473:pathology / Q000556:secondary*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D012598:Sclerosis; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000473:pathology* / Q000532:radiotherapy
D002272:Carcinoembryonic Antigen