Background The tall cell variant of papillary thyroid carcinoma is an aggressive subtype that generally present as large tumors in advanced stage. However, little is known about the tall cell variant of microcarcinoma (tumors measuring <1 cm). In this study, we compare tall cell variant of microcarcinoma with classic papillary microcarcinomas to examine the hypothesis that despite the small size, the tall cell microcarcinoma may be more aggressive than the classic papillary microcarcinoma. Patients and Methods We identified 27 tall cell microcarcinomas and compared their clinicopathological features and BRAFV600E mutational status with age and size matched classic papillary microcarcinomas. The patients with tall cell microcarcinomas included 22 women and 5 men aged 33 to 74 years (median 56 years). All patients underwent total thyroidectomy, with lymph node dissection in 20 patients. Results Tumor size in tall cell microcarcinomas ranged from 2 mm to 10 mm (median 7 mm). Extrathyroidal extension and lymphovascular invasion were seen in 9 (33%) and 4 (15%) tumors respectively. Thirteen patients (48%) harbored multifocal papillary carcinomas. Metastasis to central compartment lymph nodes was seen in 8 patients, and to lateral cervical nodes in 3 patients. Nine of the 25 patients (36%) presented at advanced stage (stage III/IVA). The BRAFV600E mutation was detected in 25 of 27 tumors (92.6%). In contrast, age and size matched classic papillary microcarcinomas (n=26) showed no extrathyroidal extension (p=0.002), lymphovascular invasion in 1, central compartment lymph node metastasis in 2, lateral cervical node metastasis in 1, multifocal tumors in 10 (38.5%), BRAFV600E mutation in 20 (76.9%), and infrequently presented in stage III/IV (7.7%, p=0.02). Conclusions The tall cell variant of papillay thyroid microcarcinoma is associated with aggressive features at presentation, and should be differentiated from other papillary thyroid microcarcinomas.
Bernstein JI, Virk R, Hui P, Prasad A, Westra WH, Tallini G, et al. (2013). Tall Cell Variant of Papillary Thyroid Microcarcinoma: Clinicopathological Features with BRAFV600E Mutational Analysis. THYROID, 23((12)), 1525-1531 [10.1089/thy.2013.0154].
Tall Cell Variant of Papillary Thyroid Microcarcinoma: Clinicopathological Features with BRAFV600E Mutational Analysis
TALLINI, GIOVANNI;
2013
Abstract
Background The tall cell variant of papillary thyroid carcinoma is an aggressive subtype that generally present as large tumors in advanced stage. However, little is known about the tall cell variant of microcarcinoma (tumors measuring <1 cm). In this study, we compare tall cell variant of microcarcinoma with classic papillary microcarcinomas to examine the hypothesis that despite the small size, the tall cell microcarcinoma may be more aggressive than the classic papillary microcarcinoma. Patients and Methods We identified 27 tall cell microcarcinomas and compared their clinicopathological features and BRAFV600E mutational status with age and size matched classic papillary microcarcinomas. The patients with tall cell microcarcinomas included 22 women and 5 men aged 33 to 74 years (median 56 years). All patients underwent total thyroidectomy, with lymph node dissection in 20 patients. Results Tumor size in tall cell microcarcinomas ranged from 2 mm to 10 mm (median 7 mm). Extrathyroidal extension and lymphovascular invasion were seen in 9 (33%) and 4 (15%) tumors respectively. Thirteen patients (48%) harbored multifocal papillary carcinomas. Metastasis to central compartment lymph nodes was seen in 8 patients, and to lateral cervical nodes in 3 patients. Nine of the 25 patients (36%) presented at advanced stage (stage III/IVA). The BRAFV600E mutation was detected in 25 of 27 tumors (92.6%). In contrast, age and size matched classic papillary microcarcinomas (n=26) showed no extrathyroidal extension (p=0.002), lymphovascular invasion in 1, central compartment lymph node metastasis in 2, lateral cervical node metastasis in 1, multifocal tumors in 10 (38.5%), BRAFV600E mutation in 20 (76.9%), and infrequently presented in stage III/IV (7.7%, p=0.02). Conclusions The tall cell variant of papillay thyroid microcarcinoma is associated with aggressive features at presentation, and should be differentiated from other papillary thyroid microcarcinomas.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
