Comparison of the clinicopathologic features of solitary and multifocal papillary thyroid carcinoma and the utility of testing an additional tumor nodule for BRAFV600E in multifocal cases
Journal Title: Journal of Modern Human Pathology - Year 2017, Vol 2, Issue 1
Abstract
A retrospective review of the tumor focality and BRAFV600E mutational status of all thyroidectomy cases diagnosed with papillary thyroid carcinoma (PTC) between 1/2010 and 7/2013 was performed. A total of 122 cases were included in this study consisting of 65 solitary cases and 57 multifocal cases with a total of 209 tumor nodules. In the multifocal tumors with absent BRAFV600E mutation in the dominant nodule, an additional tumor focus was submitted for testing. The clinicopathologic characteristics of the cases were then compared and analyzed. Significant association with BRAFV600E mutation was driven by previously established unfavorable histologic features such as usual variant, capsular invasion, lymphovascular invasion, extrathyroidal extension, and lymph node metastasis. We did not establish this association with tumor multifocality in this study. Although more cases of mPTC (multifocal papillary thyroid carcinoma) had BRAFV600E mutation in comparison with the solitary cases (56 vs 44%), we did not find a significant difference between the two groups (p = 0.0689). Furthermore, at least one of the unfavorable histologic features was also noted in three out of the five multifocal cases with discordant mutations in the two largest nodules. The heterogeneity of BRAFV600E mutational status in mPTC is evident in this study and although it seems prudent to further test additional foci, it appears that in most cases there are already histologic features that support a more aggressive behavior. Selective testing based on histomorphology may be a more practical approach in these cases.
Authors and Affiliations
Tan J, de las Morenas A, Yang S, Xu H
Keywords
Related Articles
- EP ID EP552615
- DOI 10.14312/2397-6845.2017-1
- Views 68
- Downloads 0
Spatiotemporal expression of matrix metalloproteinase-1 in progression of nonalcoholic steatohepatitis
Human matrix metalloproteinase-1 (MMP-1) has been shown to contribute to the regression of experimental liver fibrosis when ectopically expressed in rodents. It remains unknown whether the same mechanism exists in chroni...
Atypical presentation of a desmoplastic small round cell tumor in the orbit: Case report and review of the literature
Desmoplastic small round cell tumor (DSRCT) is a rare malignant neoplasm. Typically it occurs in young adult males and involves the abdomen or pelvis. Other primary sites are uncommon. Only one other case of orbital DSRC...
Laparoscopic management of primary abdominal pregnancy located on the sigmoid colon: A case report
Abdominal pregnancy (AP) is rare with an estimated incidence of 1/10000 births and only 1.4% of ectopic pregnancies. Primary abdominal pregnancy (PAP) is the least common form of the AP. We present a case of PAP in a 22...
Azathioprine induced Epstein-Barr virus positive mucocutaneous ulcer: A case report
Introduction: Epstein-Barr virus positive mucocutaneous ulcer (EBVMUC) is a rare, newly described provisional entity in the 2016 Update of World Health Organization classification of lymphoid neoplasms. The histomorpholo...
Heterotopic mesenteric ossification: Report of two cases with review of the literature
Very few cases of heterotopic mesenteric ossification (HMO) have been reported in the literature. We describe two cases, one at an early phase and the other at a more advanced stage of the disease. Both patients develope...