title: Primary squamous cell carcinoma of the thyroid diagnosed as anaplastic carcinoma: failure in fine-needle aspiration cytology?
abstract: A case of primary squamous-cell carcinoma (SCC) of the thyroid which had been initially diagnosed as an anaplastic carcinoma (ATC) is described: female, 73 years old, with a fast-growing cervical nodule on the left side and hoarseness for 3 months. Ultrasonography showed a 4.5 cm solid nodule. FNA was compatible with poorly differentiated carcinoma with immunoreactivity for AE1/AE3, EMA. Thyroidectomy was performed. Histopathological examination showed a nonencapsulated tumor. Immunohistochemistry disclosed positivity for AE1/AE3, p53,p63, and Ki67. The diagnosis was ATC. A second opinion reported tumor consisting of squamous cells, with intense inflammatory infiltrate both in tumor and in the adjacent thyroid, with final diagnosis of SCC, associated with Hashimoto thyroiditis. No other primary focus of SCC was found. Patient has shown a 48-month survival period. Clinically, primary SCCs of the thyroid and ATCs are similar. The distinction is often difficult particularly when based on the cytological analysis of FNA material.
authors.affiliation: Division of Endocrinology and Metabolism, Internal Medicine Department, Botucatu Medical School, São Paulo State University (UNESP), 18618-000 Botucatu, SP, Brazil.
authors.forename: Fernanda
authors.identifier: 0000-0002-1444-592X
authors.initials: F
authors.lastname: Bolfi
authors.affiliation: Pathology Department, Botucatu Medical School, São Paulo State University (UNESP), 18618-000 Botucatu, SP, Brazil.
authors.forename: Maria A C
authors.initials: MA
authors.lastname: Domingues
authors.affiliation: Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), 4200-465 Porto, Portugal.
authors.forename: Manuel
authors.initials: M
authors.lastname: Sobrinho-Simões
authors.affiliation: Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), 4200-465 Porto, Portugal.
authors.forename: Paula
authors.identifier: 0000-0001-9607-6998
authors.initials: P
authors.lastname: Soares
authors.affiliation: Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), 4200-465 Porto, Portugal.
authors.forename: Ricardo
authors.identifier: 0000-0002-9605-6433
authors.initials: R
authors.lastname: Celestino
authors.affiliation: Head and Neck Department, Botucatu Medical School, São Paulo State University (UNESP), 18618-000 Botucatu, SP, Brazil.
authors.forename: Emanuel C
authors.initials: EC
authors.lastname: Castilho
authors.affiliation: Division of Clinical Oncology, Internal Medicine Department, Botucatu Medical School, São Paulo State University (UNESP), 18618-000 Botucatu, SP, Brazil.
authors.forename: Guareide
authors.initials: G
authors.lastname: Carelli
authors.affiliation: Division of Radiotherapy, Department of Dermatology and Radiotherapy, Botucatu Medical School, São Paulo State University (UNESP), 18618-000 Botucatu, SP, Brazil.
authors.forename: Norberto S
authors.initials: NS
authors.lastname: Paes
authors.affiliation: Division of Endocrinology and Metabolism, Internal Medicine Department, Botucatu Medical School (FMB), São Paulo State University (UNESP), 18618-000 Botucatu, SP, Brazil.
authors.forename: Glaucia M F S
authors.initials: GM
authors.lastname: Mazeto