Well Differentiated Thyroid Carcinoma with Insular Component

Insular Component가 공존한 고분화 갑상선암

  • Chung Woong-Yoon (Departments of Surgery, Yonsei University College of Medicine) ;
  • Shim Jeong-Yun (Departments of Pathology, Yonsei University College of Medicine) ;
  • Park Cheong-Soo (Departments of Surgery, Yonsei University College of Medicine)
  • 정웅윤 (연세대학교 의과대학 외과학교실) ;
  • 심정연 (연세대학교 의과대학 병리학교실) ;
  • 박정수 (연세대학교 의과대학 외과학교실)
  • Published : 1997.05.01

Abstract

We have experienced 5 cases of unusual well differentiated thyroid carcinoma with insular component during the past 5 years. 4 cases were presented with cervical masses but I case (patient 2.) was initiallty with lung and brain metastasis. The tumors from 4 cases showed invasive growths but that of 1 cases(patient 1.) showed intrathyroidal. Total thyroidectomy and cervical lymphnode dissection(CCND or RND) was performed in 4 cases but only RND was performed in spite of mediastinal metastasis of the tumor in patient 5 under the patient's choice. During the follow-up period, we also performed radical nephrectomy and metastatectomy for the kidney and iliac bone metastasis respectively, in patint 2. Microcsopically, the tumors showed the insular growth patterns, focally(less than 50%) in 3 cases and predominantly(more than 75%) in 2 cases. And the insular componentas were combined with papillary carcinoma in 2 cases and follicular carcinoma in 3 cases. Cervical lymphnode metastases were confirmed in 4 cases. Patient 2 died of disease with metastases to lung, brain, bone and kidney, 52 months after initial therapy. Patient 1, 3 and 4 are alive and have no recurrence and distant metastasis. Patient 5 is also alive with the mediastinal metastasis. In our experience, the well differentiated thyroid carcinomas with insular component showed characteristic histologic features, aggressive behavior in initial presentation and unfavorable prognosis regardless of the percentage of the insular component.

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