Does every classical type of well-differentiated thyroid cancer have excellent prognosis? A case series and literature review

Figures & data

Figure 1 Lymph node metastases/recurrences of the aggressive forms of well-differentiated thyroid cancers. (A) 48-year-old woman with metastases of papillary thyroid cancer to the left neck lymph nodes. (B) 69-year-old woman with neck lymph node recurrence of follicular thyroid cancer 1 year after thyroidectomy. (C) 84-year-old woman with metastases of follicular thyroid carcinoma to the lymph nodes and lung. (D) 54-year-old man with papillary thyroid cancer and metastases to the lymph nodes and infiltration of the trachea and recurrent laryngeal nerve.

Table 1 Descriptive characteristics of patients with the aggressive form of the classical type of WDTC

Year	HP	Age	Gender	TNM (Figure)	IHC	Site and time (months number) of recurrence (Figure)	Metastases (Figure)	Infiltration (Figure)	Symptoms (Figure)	TBSRTC Category	Treatment (Figure)
2009	PTC	59	Female	pT4mN1bM0	CK19+HBME+CD56-	Neck lymph nodes	Lymph nodes	–	MNG (2A)	2	Total thyroidectomy
2009	FTC	77	Female	pT2mN1M1	CK19++HBME+CD56-	Neck lymph nodes and skin (12) (2B)	Lymph nodes, neck skin (2B)	Trachea, neck muscle	Dyspnea	3	Total thyroidectomy
2010	PTC	72	Female	pT4N0M0	TG++ EMA+, CK-8+ Kalc, LCA TTF CD20, CD79	Neck lymph nodes (21)	–	Trachea (4AC)	Dyspnea (4AC)	2	Near-total thyroidectomy
2011	PTC	61	Female	pT1maN0M1	CK19-Kalcyt-Chromogr-TG-	–	Vertebral column Th12/S1-2 (2D)	–	Back pain (2D)	–	Total thyroidectomy
2011	FTC	84	Female	pT4N1M1	CK19-	–	Lymph nodes (1C), lungs	Left carotid	Neck tumor	5	Surgical biopsy
2011	PTC	38	Female	pT1maN0M0	CK19++HBME+CD56-	Neck lymph nodes (23)	–	–	Thyroid tumor	6	Total thyroidectomy
2015	PTC	54	Male	pT4N1M0	CK19++CD56-	Neck lymph nodes (19)	Lymph nodes (1D)	Trachea, RLN	Hoarseness	4	Near-total thyroidectomy
2015	PTC	79	Female	pT4aN1bM0	CK19+HBME+CD56-	–	Lymph nodes	Trachea, esophagus (4D)	Dysphagia (4D), dyspnea	5	Surgical biopsy
2015	FTC	74	Male	pT4NxM0	TTF+TG+CD56+CyklinaD1+CK19+HBME1-CEA-Kalcyt-	–	–	Trachea, right carotid, RLN	Dyspnea, hoarseness	4	Surgical biopsy
2016	PTC	65	Male	pT4mN0M0	CK19++HBME++CD56-	Neck lymph nodes (19)	–	Trachea, RLN (4B)	Dyspnea, hoarseness	5	Near-total thyroidectomy (4B)
2016	FTC	69	Female	pT2N0M1 (3AC)	CD34-	Neck lymph nodes (12) (1B)	Vertebral column Th3 (3BD)	Trachea,	Paresis of the lower limbs (2C)	5	Total thyroidectomy
2016	PTC	31	Female	pT4mN1M0	CK19+HBME+CK5/6-CD56-	Neck lymph nodes (13)	Lymph nodes	Trachea	Dyspnea	5	Near-total thyroidectomy
2016	PTC	48	Female	pT1aN1M0	CK19++HBME+CD56-	Neck lymph nodes (10)	Lymph nodes (1A)	Trachea	Thyroid tumor	5	Total thyroidectomy
2016	PTC	41	Female	pT1bN1M0	CK19+HBME-1+CD56+	Neck lymph nodes	Lymph nodes	Trachea	Thyroid tumor	5	Total thyroidectomy

Abbreviations: HP, histopathology; TNM, classification proposed by the Union Internationale Contre le Cancer [UICC] and the American Joint Committee on Cancer [AJCC] 7^th edition from 2010; IHC, immunohistochemistry; TBSRTC, The Bethesda System for Reporting Thyroid Cytology; PTC, papillary thyroid cancer; FTC, follicular thyroid cancer; RLN, recurrent laryngeal nerve; WDTC, well-differentiated thyroid cancer.

Figure 2 (A) 69-year-old woman with a small follicular thyroid cancer localized in the left lobe. (B) Follicular thyroid cancer metastasis to Th3 of the vertebral column. (C) Aggressive type of the classical type of papillary thyroid cancer metastasis to S1 manifesting severe back pain several months before proper diagnosis in a 61-year-old female. (D) Th3 corporectomy and transpedicular stabilization of Th2 and Th4-Th6.