Evidence-Based Diagnosis and Treatment for a Patient with Thyriod Carcinoma Showing Thymus-like Differentiation_Chinese Journal of Evidence-Based Medicine

Authors：

BA Ya ¹ , GUO Yong ¹ ,  QIN Yongde ¹ , XIE Bin ¹ , LIU Lishui ¹ , LIU Xia ²

1. Department of Nuclear Medicine, The First Hospital Affiliated to Xinjiang Medical University, Urumqi 830011, China;2. Department of Pathology, The First Hospital Affiliated to Xinjiang Medical University, Urumqi 830011, China;

Corresponding author：

QIN Yongde, Email: qyd199013@yahoo.com.cn

Keywords：

Thyroid carcinoma showing thymus-like elements; Evidence-based diagnosis; Evidence-based treatment

DOI：

10.7507/1672-2531.20110060

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Objective 　To discuss the diagnosis, treatment, and follow-up visit mode of thyroid carcinoma showing thymus-like elements (CASTLE).
Mothods 　For a systematic review of a case with CASTLE, the domestic and overseas literature was searched to analyze final diagnosis, treatment and follow-up visit indexes of that case. Results 　For CASTLE, the pathology combined with immunohistochemistry was the only method for final diagnosis, the operation was the main treatment, and the ultrasound as well as the computed tomography (CT) could be the follow-up visiting indexes.
Conclusion 　CASTLE is a special kind of thyroid carcinoma, which is different from differentiated thyroid carcinoma in diagnosis, treatment and follow-up visit.

Citation： BA Ya,GUO Yong,QIN Yongde,XIE Bin,LIU Lishui,LIU Xia. Evidence-Based Diagnosis and Treatment for a Patient with Thyriod Carcinoma Showing Thymus-like Differentiation. Chinese Journal of Evidence-Based Medicine, 2011, 11(3): 350-353. doi: 10.7507/1672-2531.20110060 Copy

1.	1 Miyauchi A, Kuma K, Matsuzuka F, et al . Intrathyroidal epithelial thymoma: an entity distinct from squamous cell carcinoma of the thyroid. World J Surg , 1985, 9(1): 128-134.
2.	Ahuja AT, Chan ES, Allen PW, et al . Carcinoma showing thymic-like differentiation (CASTLE tumor). AJNR Am J Neuroradiol , 1998, 19(8): 1225-1228.
3.	Yoneda K, Matsui O, Kobayashi T, et al . CT and MRI findings of carcinoma showing thymus-like differentiation. Radiat Med , 2005, 23(6): 451-455.
4.	Mizukami Y, Kurumaya H, Yamada T, et al . Thymic carcinoma involving the thyroid gland: report of two cases. Hum Pathol , 1995, 26(5): 576-579.
5.	Miyauchi A, Ishikawa H, Maeda M. Intrathyroidal epithelial thymoma: a report of 6 cases with immunohistochemical and ultrastructural studies. Endocr Surg , 1989, 6(3): 289-295.
6.	Kakudo K, Mori I, Tamaoki N, et al . Carcinoma of possible thymic origin presenting as a thyroid mass: a new subgroup of squamous cell carcinoma of the thyroid. J Surg Oncol , 1988, 38(3): 187-192.
7.	Kusada N, Hara Y, Kobayashi S, et al . A case of aggressive carcinoma showing thymus-like differentiation with distant metastases. Thyroid , 2005, 15(12): 1383-1388.
8.	Chan JK, Rosai J. Tumors of the neck showing thymic or related branchial pouch differentiation: a unifying concept. Hum Pathol , 1991, 22(3): 349-367.
9.	Roka S, Kornek G, Schuller J, et al . Carcinoma showing thymic-like elements—a rare malignancy of the thyroid gland. Br J Surg , 2004, 91(1): 142-145.
10.	Berezowski K, Grimes MM, Gal A, et al . CD5 immunoreactivity of epithelial cells in thymic carcinoma and CASTLE using paraffin-embedded tissue. Am J Clin Pathol , 1996, 106(4): 483-486.
11.	Dorfman DM, ShahsafaeiA, Miyauchi A. Intrathyroidal epithelial thymoma (ITET)/ carcinoma showing thymuslike differentiation (CASTLE) exhibits CD5 immunoreactivity: new evidence for thymic differentiation. Histopathology , 1998, 32(1): 104-109.
12.	Kakudo K, Mori I, Tamaoki N, et al . Carcinoma of possible thymic origin presenting as a thyroid mass: A new subgroup of squamous cell carcinoma of the thyroid. J Surg Oncol , 1988, 38(1): 187-192.
13.	Damiani S, Filotico M, Eusebi V. Carcinoma of the thyroid showing thymoma-like features. Virchows Arch A Pathol Anat Histopatho l, 1991, 18(5): 463-466.
14.	Luo CM, Hsueh C, Chen TM. Extrathyroid carcinoma showing thymus-like differentiation (CASTLE) tumor—a new case report and review of literature. Head Neck , 2005, 27(10): 927-933.
15.	Chung JK, Park YJ, Kim TY, et al . Clinical significance of elevated level of serum antithyroglobulin antibody in patients with differentiated thyroid cancer after thyroid ablation. Clin Endocrinol (Oxf) , 2002, 57(2): 215-221.
16.	Mitchell G, Pratt BE, Vini L, et al . False positive 131 I whole body scans in thyroid cancer. Br J Radiol, 2000,73(870): 627-635.
17.	Lind P, Kresnik E, Kumnig G, et al . 18 F-FDG PET in the follow-up of thyroid cancer. Acta Med Austriaca , 2003, 30(1): 17-21.
18.	Hsu CH, Liu RS, Wu CH, et al . Complementary role of 18 F2fluorodeoxyglucose positron emission tomography and 131 I scan in the follow-up of post-therapy differentiated thyroid cancer. J Formos Med Assoc , 2002, 101(7): 459-467.
19.	陈立波, 罗全勇, 余永利, 等. 分化型甲状腺癌患者的 131 I-SPECT/ CT 断层融合显像. 中国医学影像技术, 2004, 20(1): 111-113.
20.	Cooper DS, Specker B, Ho M, et al . Thyrotropin suppression and disease progression in patients with differentiated thyroid cancer: Results from the National Thyroid Cancer Treatment Cooperative Registry. Thyroid , 1998, 8(7): 737-744.
21.	Tai CM, Liang CW, Chang TC .Intrathyroidal thymic carcinoma: A case report. J Formos Med Assoc , 2003, 102(1): 109-112.
22.	Chan LP, Chiang FY, Lee KW, et al . Carcinoma showing thymus-like differentiation (CASTLE) of thyroid: a case report and literature review. Kaohsiung J Med Sci , 2008, 24(5): 591-597.
23.	McGriff NJ, Csako G, Gourgiotis L, et al . Effects of thyroid hormone suppression therapy on adverse clinical outcomes in thyroid cancer. Ann Med , 2002, 34(7): 554-564.
24.	Marco A, Mohamed SB, Carmen D, et al . Carcinoma showing thymus-like elements invading the trachea. J Thorac Cardiovasc Surg , 2006, 132(1): 191-192.

1. 1 Miyauchi A, Kuma K, Matsuzuka F, et al . Intrathyroidal epithelial thymoma: an entity distinct from squamous cell carcinoma of the thyroid. World J Surg , 1985, 9(1): 128-134.
2. Ahuja AT, Chan ES, Allen PW, et al . Carcinoma showing thymic-like differentiation (CASTLE tumor). AJNR Am J Neuroradiol , 1998, 19(8): 1225-1228.
3. Yoneda K, Matsui O, Kobayashi T, et al . CT and MRI findings of carcinoma showing thymus-like differentiation. Radiat Med , 2005, 23(6): 451-455.
4. Mizukami Y, Kurumaya H, Yamada T, et al . Thymic carcinoma involving the thyroid gland: report of two cases. Hum Pathol , 1995, 26(5): 576-579.
5. Miyauchi A, Ishikawa H, Maeda M. Intrathyroidal epithelial thymoma: a report of 6 cases with immunohistochemical and ultrastructural studies. Endocr Surg , 1989, 6(3): 289-295.
6. Kakudo K, Mori I, Tamaoki N, et al . Carcinoma of possible thymic origin presenting as a thyroid mass: a new subgroup of squamous cell carcinoma of the thyroid. J Surg Oncol , 1988, 38(3): 187-192.
7. Kusada N, Hara Y, Kobayashi S, et al . A case of aggressive carcinoma showing thymus-like differentiation with distant metastases. Thyroid , 2005, 15(12): 1383-1388.
8. Chan JK, Rosai J. Tumors of the neck showing thymic or related branchial pouch differentiation: a unifying concept. Hum Pathol , 1991, 22(3): 349-367.
9. Roka S, Kornek G, Schuller J, et al . Carcinoma showing thymic-like elements—a rare malignancy of the thyroid gland. Br J Surg , 2004, 91(1): 142-145.
10. Berezowski K, Grimes MM, Gal A, et al . CD5 immunoreactivity of epithelial cells in thymic carcinoma and CASTLE using paraffin-embedded tissue. Am J Clin Pathol , 1996, 106(4): 483-486.
11. Dorfman DM, ShahsafaeiA, Miyauchi A. Intrathyroidal epithelial thymoma (ITET)/ carcinoma showing thymuslike differentiation (CASTLE) exhibits CD5 immunoreactivity: new evidence for thymic differentiation. Histopathology , 1998, 32(1): 104-109.
12. Kakudo K, Mori I, Tamaoki N, et al . Carcinoma of possible thymic origin presenting as a thyroid mass: A new subgroup of squamous cell carcinoma of the thyroid. J Surg Oncol , 1988, 38(1): 187-192.
13. Damiani S, Filotico M, Eusebi V. Carcinoma of the thyroid showing thymoma-like features. Virchows Arch A Pathol Anat Histopatho l, 1991, 18(5): 463-466.
14. Luo CM, Hsueh C, Chen TM. Extrathyroid carcinoma showing thymus-like differentiation (CASTLE) tumor—a new case report and review of literature. Head Neck , 2005, 27(10): 927-933.
15. Chung JK, Park YJ, Kim TY, et al . Clinical significance of elevated level of serum antithyroglobulin antibody in patients with differentiated thyroid cancer after thyroid ablation. Clin Endocrinol (Oxf) , 2002, 57(2): 215-221.
16. Mitchell G, Pratt BE, Vini L, et al . False positive 131 I whole body scans in thyroid cancer. Br J Radiol, 2000,73(870): 627-635.
17. Lind P, Kresnik E, Kumnig G, et al . 18 F-FDG PET in the follow-up of thyroid cancer. Acta Med Austriaca , 2003, 30(1): 17-21.
18. Hsu CH, Liu RS, Wu CH, et al . Complementary role of 18 F2fluorodeoxyglucose positron emission tomography and 131 I scan in the follow-up of post-therapy differentiated thyroid cancer. J Formos Med Assoc , 2002, 101(7): 459-467.
19. 陈立波, 罗全勇, 余永利, 等. 分化型甲状腺癌患者的 131 I-SPECT/ CT 断层融合显像. 中国医学影像技术, 2004, 20(1): 111-113.
20. Cooper DS, Specker B, Ho M, et al . Thyrotropin suppression and disease progression in patients with differentiated thyroid cancer: Results from the National Thyroid Cancer Treatment Cooperative Registry. Thyroid , 1998, 8(7): 737-744.
21. Tai CM, Liang CW, Chang TC .Intrathyroidal thymic carcinoma: A case report. J Formos Med Assoc , 2003, 102(1): 109-112.
22. Chan LP, Chiang FY, Lee KW, et al . Carcinoma showing thymus-like differentiation (CASTLE) of thyroid: a case report and literature review. Kaohsiung J Med Sci , 2008, 24(5): 591-597.
23. McGriff NJ, Csako G, Gourgiotis L, et al . Effects of thyroid hormone suppression therapy on adverse clinical outcomes in thyroid cancer. Ann Med , 2002, 34(7): 554-564.
24. Marco A, Mohamed SB, Carmen D, et al . Carcinoma showing thymus-like elements invading the trachea. J Thorac Cardiovasc Surg , 2006, 132(1): 191-192.

Chinese Journal of Evidence-Based Medicine

Evidence-Based Diagnosis and Treatment for a Patient with Thyriod Carcinoma Showing Thymus-like Differentiation

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