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Anaplastic Thyroid Carcinoma or Thyroid Metastasis from Cholangiocarcinoma? A Case Report | OMICS International | Abstract
[Jurnalul de Chirurgie]
ISSN: 1584-9341

Journal of Surgery
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Case Report

Anaplastic Thyroid Carcinoma or Thyroid Metastasis from Cholangiocarcinoma? A Case Report

Lidia Ionescu1, Radu Danila1*, Mihaela Blaj2, Mihai Savin3, Carmen Vulpoi4, Delia Ciobanu5 and Daniel Timofte1

1Department of General Surgery, University of Medicine and Pharmacy “Gr.T. Popa” Iasi, “St. Spiridon” Hospital, Iasi, Romania

2Intensive Care Unit, University of Medicine and Pharmacy “Gr.T. Popa” Iasi, “St. Spiridon” Hospital, Iasi, Romania

3Department of Radiology, “St. Spiridon” Hospital, Iasi, Romania

4Department of Endocrinology, University of Medicine and Pharmacy “Gr.T. Popa” Iasi, “St. Spiridon” Hospital, Iasi, Romania

5Department of Pathology, University of Medicine and Pharmacy “Gr.T. Popa” Iasi, “St. Spiridon” Hospital, Iasi, Romania

*Corresponding Author:
Radu Danila
3rd Surgical Unit
“St. Spiridon” Hospital
Bd. Independentei, No 1
700111, Iasi, Romania
Tel: +40 (0) 232 217 781
E-mail: [email protected]

Received Date: March 13, 2014; Accepted Date: May 20, 2014; Published Date: May 27, 2014

Citation: Ionescu L, Danila R, Blaj M, Savin M, Vulpoi C, et al. Anaplastic Thyroid Carcinoma or Thyroid Metastasis from Cholangiocarcinoma? A Case Report. Journal of Surgery [Jurnalul de chirurgie] 2015; 11(2): 381-383 DOI:10.7438/1584-9341-11-2-7

Copyright: © 2015 Ionescu L, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Anaplastic thyroid carcinoma presents as an extremely localy invasive neck mass while metastases in the thyroid are most commonly described as small, indolent, solitary nodules usually originating from kidney, breast, lungs and skin tumors. We report the case of a 74-year old male patient illustrating the difficulties of differential diagnosis between an anaplastic thyroid carcinoma and a thyroid metastasis of a peripheral cholangiocarcinoma in a cirrhotic patient diagnosed and operated for a locally advanced thyroid tumor. The history, clinical and imagistical features strongly pleaded for the diagnosis of anaplastic thyroid carcinoma presumably with liver metastases, also supported by the rapid recurrence following total thyroidectomy. Immunohistochemical tests showed a malignant carcinomatous proliferation with anaplastic prophile. Positive immunochemical staining for cytokeratin AE1/AE3, CK7 and negative CK20, AFP, CD15, CD30, CD5, TTF1 and thyroglobulin directed the possible diagnosis toward a secondary thyroid tumor from a peripheral cholangiocarcinoma. Immunohistochemical tests showed a malignant carcinomatous proliferation with anaplastic prophile. Positive immunochemical staining for cytokeratin AE1/AE3, CK7 and negative CK20, AFP, CD15, CD30, CD5, TTF1 and thyroglobulin directed the possible diagnosis toward a secondary thyroid tumor from a peripheral cholangiocarcinoma. A CT-guided percutaneous hepatic punction biopsy was planned but the patient presented an ischemic stroke with fatal outcome. In conclusion, in spite of surgical treatment the rapid recurrent thyroid cancer either primary or metastatic had a poor prognosis with fatal outcome mainly in the presence liver cirrhosis and cardio-vascular co-morbidities.

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