Case Report
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World J Clin Oncol. Dec 10, 2014; 5(5): 1117-1120
Published online Dec 10, 2014. doi: 10.5306/wjco.v5.i5.1117
Thyroid carcinoma showing thymus-like differentiation: Case presentation of a young man
Chiara Abeni, Chiara Ogliosi, Luigina Rota, Paola Bertocchi, Alessandra Huscher, Giordano Savelli, Mariano Lombardi, Alberto Zaniboni
Chiara Abeni, Chiara Ogliosi, Luigina Rota, Paola Bertocchi, Alberto Zaniboni, Department of Medical Oncology, Fondazione Poliambulanza, 25124 Brescia, Italy
Alessandra Huscher, Department of Radiotherapy, Fondazione Poliambulanza, 25124 Brescia, Italy
Giordano Savelli, Department of Nuclear Medicine, Fondazione Poliambulanza, 25124 Brescia, Italy
Mariano Lombardi, Department of Pathology, Fondazione Poliambulanza, 25124 Brescia, Italy
Author contributions: Abeni C, Ogliosi C, Rota L, Huscher A, Savelli G, Lombardi M and Zaniboni A diagnosed and followed the patient; Huscher A performed the radiotherapy; Savelli G performed and interpreted the PET; Lombardi M interpreted the histological data; Abeni C, Ogliosi C, Bertocchi P and Rota L prepared the manuscript; Zaniboni A evaluated the draft and suggested revisions; all authors read and approved the final manuscript.
Correspondence to: Alberto Zaniboni, MD, Department of Medical Oncology, Fondazione Poliambulanza, Via Bissolati 57, 25124 Brescia, Italy. zanib@numerica.it
Telephone: +39-03-03515309 Fax: +39-03-03518270
Received: March 31, 2014
Revised: September 23, 2014
Accepted: October 14, 2014
Published online: December 10, 2014
Processing time: 254 Days and 15.4 Hours
Abstract

Ectopic thymic tissue can be present in the thyroid gland and a carcinoma showing thymus-like differentiation (CASTLE) may arise from such tissue. We are reported the case of a 26-year-old man with CASTLE, with cervical subcutaneous nodules relapse, who showed a good response to treatment with surgery, chemotherapy and radiotherapy. The problematic aspect of this case was the diagnosis; only on review were we able to make a final diagnosis. CASTLE is a very rare neoplasm. It is important to differentiate this cancer from others tumors such as primary or metastatic squamous cell carcinoma of the head and neck or squamous cell thyroid carcinoma, because the therapy and prognosis are different. Diagnosis is complicated and requires careful histological analysis (CD5- and P63-positive with presence of Hassall’s corpuscles); unfortunately there is no gold standard treatment so, in this case, we administered a sandwich of chemotherapy and radiotherapy.

Keywords: Carcinoma showing thymus-like differentiation; thymic; CD5; Hassall’s corpuscles; Thyroidectomy; Chemotherapy; Radiotherapy

Core tip: Carcinoma showing thymus-like differentiation (CASTLE) is a very rare tumor and is very important to differentiate it from others head and neck tumors because therapy and prognosis are different. Moreover, diagnosis is often complicated. Case reports on this topic, reporting treatment modalities, are useful, because there is no standard treatment for CASTLE.