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Rufini, Vittoria; Salvatori, Massimo; Fadda, Guido; Pinnarelli, Luigi; Castaldi, Paola; Maussier, Maria Lodovica; Galli, Guido

Thyroid carcinomas with a variable insular component : Prognostic significance of histopathologic patterns

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  • Media type: E-Article
  • Title: Thyroid carcinomas with a variable insular component : Prognostic significance of histopathologic patterns : Prognostic significance of histopathologic patterns
  • Contributor: Rufini, Vittoria; Salvatori, Massimo; Fadda, Guido; Pinnarelli, Luigi; Castaldi, Paola; Maussier, Maria Lodovica; Galli, Guido
  • imprint: Wiley, 2007
  • Published in: Cancer
  • Language: English
  • DOI: 10.1002/cncr.22913
  • ISSN: 0008-543X; 1097-0142
  • Origination:
  • Footnote:
  • Description: <jats:title>Abstract</jats:title><jats:sec><jats:title>BACKGROUND.</jats:title><jats:p>An insular growth pattern may be observed focally both in papillary and follicular thyroid carcinoma. The aim of the current study was to determine whether a greater extension of the insular component (IC) influences different clinical and histologic features at diagnosis, and a different tumor aggressiveness in terms of frequency in the occurrence of metastases as well as survival.</jats:p></jats:sec><jats:sec><jats:title>METHODS.</jats:title><jats:p>Thirty‐three patients with histopathologic findings consistent with IC were included in the study. IC was focal (&lt;50% of the tumor area) in 16 patients and predominant (&gt;50% of the tumor area) in 17 patients. These 2 groups were compared with a control group of 66 patients with differentiated thyroid carcinoma.</jats:p></jats:sec><jats:sec><jats:title>RESULTS.</jats:title><jats:p>At diagnosis, carcinomas with predominant IC differed from those with focal IC with regard to greater tumor size and a higher frequency of extrathyroidal extension and distant metastases. Patient follow‐up ranged from 5 to 188 months. The cumulative rate of distant metastases was significantly higher in patients with predominant IC. At the time of last follow‐up, carcinomas with predominant IC demonstrated a lesser frequency of disease‐free outcome (<jats:italic>P</jats:italic> = .002) and a higher number of tumor‐related deaths (<jats:italic>P</jats:italic> = .002), either when distant metastases were present (<jats:italic>P</jats:italic> = .03) or absent (<jats:italic>P</jats:italic> = .05) at the time of diagnosis.</jats:p></jats:sec><jats:sec><jats:title>CONCLUSIONS.</jats:title><jats:p>The presence of predominant IC is associated with a poor prognosis in terms of ongoing disease or death. Predominant IC should be considered a separate entity from not only the classical papillary or follicular carcinomas but also the focal IC tumor. Cancer 2007. © 2007 American Cancer Society.</jats:p></jats:sec>
  • Access State: Open Access