Undifferentiated pleomorphic sarcoma of the thyroid: A case
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Sarcomas are a rare and heterogeneous group of malignant tumors of mesenchymal origin that comprise less than one percent of all adult malignancies and 12 percent of cancers in children. Approximately 80 percent of new cases of sarcoma develop from soft tissue. Histologically, the diagnosis of a soft tissue sarcoma is made on the basis of morphologic patterns. Immunohistochemical staining often aids in the identification of the probable tissue of origin.

A 79‐year‐old woman presented with a fast‐growing, painless thyroid nodule and symptoms of dysphagia and dysphonia for six months. She reported a history of hypertension, no history of radiation to the neck, and no family history of any malignancy. She was admitted to hospital for a tentative thyroid radiofrequency ablation (RFA). On physical examination, a very large, solid, and irregular thyroid nodule was detected.

The thyroid ultrasonography showed a 45 × 32 mm mixed echogenicity mass which occupied nearly the entire thyroid gland, with no calcification, no vascularity, and no lymph node involvement. Fine Needle Aspiration (FNA) of the thyroid mass yielded hemorrhagic aspirate with diagnosis of a large benign thyroid nodule. The patient refused a core needle biopsy. A total thyroidectomy instead of RFA was performed because of compressive symptoms and high risk of malignancy.

In conclusion, in clinical practice, primary thyroid UPS presents as a rapidly growing neck tumor in the elderly patient that causes compressive symptoms similar to anaplastic thyroid cancer and thyroid lymphoma. Histopathologic features combined with immunohistochemical stains are required for diagnosis. The treatment of choice for primary thyroid UPS is complete excision with or without postoperative adjuvant radio‐ and/or chemotherapy. Although the benefits of this remain unproven.

Source: https://onlinelibrary.wiley.com/doi/full/10.1002/ccr3.2710?af=R
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Dr. S●●●●●●●●●●n K●●●●●●i
Dr. S●●●●●●●●●●n K●●●●●●i Family Medicine
Feb 13, 2020Like