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Clinicopathological characteristics of collision tumours of thyroid in the clinical setting of medullary thyroid carcinoma

Published online by Cambridge University Press:  25 October 2024

Ashwini Chalikandy ,
Sarvesh Loharkar  and
Sandip Basu Open the ORCID record for Sandip Basu [Opens in a new window]
Ashwini Chalikandy
Affiliation:
Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Hospital Annexe, Mumbai, India Homi Bhabha National Institute, Mumbai, India
Sarvesh Loharkar
Affiliation:
Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Hospital Annexe, Mumbai, India Homi Bhabha National Institute, Mumbai, India
Sandip Basu*
Affiliation:
Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Hospital Annexe, Mumbai, India Homi Bhabha National Institute, Mumbai, India
*
Corresponding author: Sandip Basu; Email: [email protected]
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Abstract

Objectives

To study the clinicopathological features of collision tumours of the thyroid and to develop a logical management regimen in view of the rarity of these tumours.

Methods

A retrospective study on collision tumours of the thyroid, diagnosed over the previous 15 years in a tertiary cancer care centre. The inclusion criteria were proven cases of collision tumours of medullary thyroid carcinoma with papillary thyroid carcinoma and/or follicular thyroid carcinoma.

Results

Among the 470 patients with medullary thyroid carcinoma, 24 were found to harbour collision tumours (5.1 per cent). Amongst 18 patients (75 per cent) with lymph node metastases, 88.8 per cent originated from medullary thyroid carcinoma and 22.2 per cent from the papillary thyroid carcinoma component. Two patients (8.3 per cent) presented with distant metastases. Eight patients underwent radioactive iodine scan, of whom seven demonstrated neck uptake and received radioactive iodine therapy. Fifteen patients (62.5 per cent) were disease free, eight patients (33.33 per cent) harboured biochemical and/or structural residual disease, and one patient died due to an unrelated aetiology.

Conclusion

Thyroid collision tumours are relatively rare entities and are usually undiagnosed pre-operatively. The prognosis of the disease primarily depends on tumour aggressiveness the of medullary thyroid carcinoma component. A combined follow up with tumour markers and imaging, including positron emission tomography/computed tomography molecular imaging approaches should be adopted.

Keywords

thyroid cancermedullarythyroid cancerpapillaryradionuclide imagingthyroglobulin
Type
Main Article
Information
The Journal of Laryngology & Otology , First View , pp. 1 - 6
Copyright
© Radiation Medicine Centre (BARC), 2025. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Sandip Basu takes responsibility for the integrity of the content of the paper

References

Bulte, CA, Hoegler, KM, Khachemoune, A. Collision tumors: a review of their types, pathogenesis, and diagnostic challenges. Dermatol Ther 2020;33:e14236Google Scholar
Negura, I, Ianole, V, Danciu, M, Preda, C, Iosep, DG, Dănilă, R, et al. Thyroid collision tumors: the presence of the medullary thyroid carcinoma component negatively influences the prognosis. Diagnostics (Basel) 2023;13:Google Scholar
Goyal, R, Parwani, AV, Gellert, L, Hameed, O, Giannico, GA. A collision tumor of papillary renal cell carcinoma and oncocytoma: case report and literature review. Am J Clin Pathol 2015;144:Google Scholar
Kim, VM, Goicochea, L, Fang, SH. Case report: collision tumour of colon leiomyosarcoma and adenocarcinoma. J Clin Diagn Res 2016;10:PD03–4Google Scholar
Kitagawa, H, Kaneko, M, Kano, M, Ibuki, Y, Amatya, VJ, Takeshima, Y, et al. Coexistence of gastrointestinal stromal tumor and leiomyosarcoma of the stomach presenting as a collision tumor: a case report and review of literature. Pathol Int 2018;68:Google Scholar
McGregor, SM, Schoolmeester, JK, Lastra, RR. Collision signet-ring stromal tumor and steroid cell tumor of the ovary: report of the first case. Int J Gynecol Pathol 2017;36:Google Scholar
Abbi, KKS, Hameed, MK, Jiang, Y, De Las Casas, LE, Schwann, TA. Pulmonary collision tumor consisting of adenocarcinoma and typical carcinoid—a case report and review of literature. Am J Ther 2014;21:e234–8Google Scholar
Bojoga, A, Stănescu, L, Badiu, C. Collision tumors of the thyroid. A special clinical and pathological entity. Arch Clin Cases 2021;8:84–90Google Scholar
Wong, RL, Kazaure, HS, Roman, SA, Sosa, JA. Simultaneous medullary and differentiated thyroid cancer: a population-level analysis of an increasingly common entity. Ann Surg Oncol 2012;19:Google Scholar
Lax, SF, Beham, A, Kronberger-Schönecker, D, Langsteger, W, Denk, H. Coexistence of papillary and medullary carcinoma of the thyroid gland – mixed or collision tumour? Clinicopathological analysis of three cases. Virchows Arch 1994;424:Google Scholar
Lamberg, BA, Reissel, P, Stenman, S, Koivuniemi, A, Ekbolm, M, Mäkinen, J, et al. Concurrent medullary and papillary thyroid carcinoma in the same thyroid lobe and in siblings. Acta Med Scand 1981;209:Google Scholar
Tanaka, T, Yoshimi, N, Kanai, N, Mori, H, Nagai, K, Fujii, A, et al. Simultaneous occurrence of medullary and follicular carcinoma in the same thyroid lobe. Hum Pathol 1989;20:Google Scholar
Thomas, A, Mittal, N, Rane, SU, Bal, M, Patil, A, Ankathi, SK, et al. Papillary and medullary thyroid carcinomas presenting as collision tumors: a case series of 21 cases at a tertiary care cancer center. Head Neck Pathol 2021;15:Google Scholar
Abdullah, AM, Qaradakhy, AJ, Ahmed, MM, Salih, AM, Omar, SS, Kakamad, FH, et al. Thyroid collision tumors; a case series with literature review. Ann Med Surg (Lond) 2022;76:Google Scholar
Kim, WG, Gong, G, Kim, EY, Kim, TY, Hong, SJ, Kim, WB, et al. Concurrent occurrence of medullary thyroid carcinoma and papillary thyroid carcinoma in the same thyroid should be considered as coincidental. Clin Endocrinol (Oxf) 2010;72:Google Scholar
Biscolla, RP, Ugolini, C, Sculli, M, Bottici, V, Castagna, MG, Romei, C, et al. Medullary and papillary tumors are frequently associated in the same thyroid gland without evidence of reciprocal influence in their biologic behavior. Thyroid 2004;14:Google Scholar
SA, Wells Jr, Asa, SL, Dralle, H, Elisei, R, Evans, DB, Gagel, RF, et al. Revised American Thyroid Association guidelines for the management of medullary thyroid carcinoma. Thyroid 2015;25:567–610Google Scholar
Kiess, AP, Agrawal, N, Brierley, JD, Duvvuri, U, Ferris, RL, Genden, E, et al. External-beam radiotherapy for differentiated thyroid cancer locoregional control: a statement of the American Head and Neck Society. Head Neck 2016;38:Google Scholar
Brierley, JD, Tsang, RW. External beam radiation therapy for thyroid cancer. Endocrinol Metab Clin North Am 2008;37:497-xiGoogle Scholar
Maia, AL, Siqueira, DR, Kulcsar, MAV, Tincani, AJ, GMFS, Mazeto, Maciel, LMZ. Diagnosis, treatment, and follow-up of medullary thyroid carcinoma: recommendations by the Thyroid Department of the Brazilian Society of Endocrinology and Metabolism [in Portuguese]. Arq Bras Endocrinol Metabol 2014;58:667–700Google Scholar