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Primary squamous cell carcinoma of the thyroid gland successfully treated with surgical resection and adjuvant chemoradiotherapy
  1. Michael M H Chu1,
  2. Omar Mirza2,
  3. Paul William Bishop3 and
  4. Vijay Pothula1
  1. 1Department of Otolaryngology, Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK
  2. 2Department of Head and Neck Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
  3. 3Department of Pathology, Manchester University NHS Foundation Trust, Manchester, Greater Manchester, UK
  1. Correspondence to Michael M H Chu; mchu{at}doctors.org.uk

Abstract

A 57-year-old woman presented with a 3-month history of an enlarging thyroid mass causing breathlessness and dysphagia. Cross-sectional imaging showed a thyroid tumour infiltrating the trachea and abutting the oesophagus. She underwent panendoscopy, total thyroidectomy and planned tracheal resection, but due to intraoperative findings, a staged procedure was planned instead. Histological analysis revealed a poorly differentiated squamous cell carcinoma (SCC) which was positive on paired box gene 8 (PAX8) immunostaining, suggesting a diagnosis of primary thyroid SCC. She subsequently underwent total laryngectomy and bilateral neck dissections followed by radiotherapy with concurrent cisplatin chemotherapy. The patient remains disease-free 22 months after treatment. Median overall survival is 10 months for macroscopically completely resected tumours. PAX8 immunostaining is a novel technique which helps with the diagnostic challenge of distinguishing between primary thyroid SCC and SCC metastatic to the thyroid from extrathyroidal sites. Complete surgical resection with adjuvant chemoradiotherapy may result in a favourable outcome despite conflicting reports in the literature.

  • chemotherapy
  • radiotherapy
  • otolaryngology / ENT
  • surgical oncology
  • thyroid disease

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Footnotes

  • Contributors MMHC was the main author responsible for the writing and compiling of all the elements of the manuscript including the editing of images. He was also involved in the design of work, drafting and revision of the manuscript. OM was involved in the conception, manuscript writing, drafting, revision and critique of the manuscript. PWB was involved in the conception, drafting and critical revision of the manuscript. He provided the images for histology and the description of histological features. VP was involved in the conception, drafting, revision and critical analysis of the final work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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