Thyroid Carcinoma. Evaluation of an Institutional Series With Reference to the Aggressive Tumor Types

    We present our institutional series of thyroid cancers.

    We analysed 1,644 cases taken from the records of the Div. of Pathology of the  Foundation “Agostino Gemelli” University Hospital of Rome  from 1st January 2016 until 30th September 2018. From this series were excluded those patients who underwent the removal of metastases or of local recurrence of thyroid carcinoma and the patients diagnosed as NIFTP. The final series accounted for 1,314 thyroid carcinomas (80% of the population taken into consideration).

    In our series 1,239 cases (94%)  were differentiated thyroid carcinomas (DTC) and papillary thyroid carcinoma (PTC) represented 93 % of cases.

    The aggressive variants (AV) of papillary carcinoma accounted for 196 cases (16% of PTC). Tall cell carcinomas either pure or admixed with classic PTC were 164 (13%  of all PTC and 84% of all AV). Hobnail features were detected in 24 cases (2%  of PTC and 12% of AV). Columnar cells were identified in 6 cases (0,5%  of PTC and 3,1% of  AV) The diffuse sclerosing variant represented 2 cases (0,2%  of PTC and 1% of AV).

    Follicular and oncocytic carcinomas accounted for 5 and 3 cases respectively. Medullary carcinoma accounted for 53 cases (4%), poorly differentiated  carcinomas for 22 cases (1,7%) and anaplastic carcinomas for 9 cases (0,7%).

    The aggressive variants of PTC represent, in our series, 16% of DTC .  They should be treated more aggressively than usual DTC and, according to the ATA guidelines, may require the administration of RAI.


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