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KMID : 0371320030640020121
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Journal of the Korean Surgical Society
2003 Volume.64 No. 2 p.121 ~ p.126
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Clinicopathologic Features of Poorly Differentiated (Insular) Carcinoma of Thyroid
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Lee Tae-Won
Oh Seung-Keun
Choi Kook-Jin
Youn Yeo-Kyu
Roh Dong-Young
Chung Ki-Wook
Chang Myung-Chul
Yoo Seong-Ho
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Abstract
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Purpose: Well-differentiated carcinomas of the thyroid run an excellent clinical course. However 10∼20% of thyroid carcinomas showed poor clinical outcomes. Insular carcinomas are an uncommon thyroglobulin-producing neoplasm, which show intermediate prognosis between well-differentiated carcinomas and undifferentiated anaplastic carcinomas, and their clinicopathologic features are poorly understood. Therefore, we aimed to investigate the clinicopathologic features and the prognosis of insular thyroid carcinomas.
Methods: We reviewed 10 patients who underwent an operation due to an insular thyroid carcinoma at Seoul National University Hospital between January 1990 and December 2001. Their clinicopathologic features and follow-up findings were retrospectively reviewed and compared.
Results: Four male and six female patients are reviewed, with a mean age of 54.8±6.4187, ranging from 37 to 69 years. Pathologically, eight of the tumors consisted of pure insular carcinoma and the others showed a papillary carcinoma as the major component and a minor insular component. The mean tumor size was 4.53 ㎝ (4.53±1.4288 ㎝). An extrathyroidal extension was present in 7 cases and a vascular invasion in 6. Distant metastasis and local relapse of the regional lymph node were seen in 9 patients. Comparing the survivor and expired groups, all the male patients were in the expired group, and the mean tumor size was larger in the expired group (5.46 ㎝ vs. 3.6 ㎝). But these differences were not statistically significant.
Conclusion: Our study revealed that insular carcinomas have distinctive clinicopathologic features, and recognition of this histologic variant is important and significant for management of these unique tumors.
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KEYWORD
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Thyroid carcinoma, Insular carcinoma, Poorly differentiated carcinoma
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