GPR: 2021 - Week 14

• GPR Quiz
• Answer
• DDx1
• DDx2
• DDx3
• Acknowledgments
• Reference(s)

Clinical history

69 yo man with a painful 6.2 cm heterogeneous mass in the left thyroid with extrathyroidal extension

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Anaplastic thyroid carcinoma Highly aggressive carcinoma composed of undifferentiated follicular cells Rapidly enlarging mass causing hoarseness, dyspnea, and dysphagia Median survival 4 months; 1 year survival rate 10-20% Cut surface: light tan and fleshy, areas of necrosis and hemorrhage Majority are infiltrating into adjacent structures

Papillary thyroid carcinoma Most common type of thyroid carcinoma (80-93%) Excellent prognosis with a life expectancy similar to general population Solid, white, firm 20% are multifocal, 10% are encapsulated Variable cysts, fibrosis, and calcification Tall cell variant: often larger (>5 cm) and grossly apparent extrathyroidal extension

Hurthle cell carcinoma Follicular neoplasm composed of >75% oncocytic tumor cells More aggressive than conventional follicular carcinoma Solid, lobulated, bright brown to mahogany color May have central scar Prone to infarction or hemorrhage

Medullary thyroid carcinoma Neuroendocrine tumor derived from C cells (calcitonin) 1-2% of thyroid carcinomas 70% sporadic, 30% familial (MEN2A or MEN2B syndrome) 5 year survival: 65-90% Solid, firm, gray-tan-yellow May have hemorrhage and necrosis

• Kara Tassinari
• Derek Kingman
• Justin Susterich

• https://www.pathologyoutlines.com/topic/thyroidUndiff.html
• https://www.pathologyoutlines.com/topic/thyroidpapillary.html
• https://www.pathologyoutlines.com/topic/thyroidtallcellvariant.html
• https://www.pathologyoutlines.com/topic/thyroidhurthle.html
• https://www.pathologyoutlines.com/topic/thyroidmedullary.html

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This week's Gross Pathology Roundup was presented by Lisa Yuen, MD, PhD on Mon, Apr 05, 2021.