Hostname: page-component-5db58dd55d-bthnr Total loading time: 0 Render date: 2026-05-25T18:23:05.715Z Has data issue: false hasContentIssue false
  • English
  • Français

Management of carcinoma showing thymus-like element

Published online by Cambridge University Press:  23 March 2010

D Biswas ,
L Karsai ,
S L Atkin  and
R J England
D Biswas*
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, Hull Royal Infirmary, University of Hull, UK Department of Otolaryngology, Sheffield Children's Hospital, UK
L Karsai
Affiliation:
Department of Histopathology, Hull Royal Infirmary, University of Hull, UK
S L Atkin
Affiliation:
Department of Endocrinology, Hull Royal Infirmary, University of Hull, UK
R J England
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, Hull Royal Infirmary, University of Hull, UK
*
Address for correspondence: Mr D Biswas, Department of Otolaryngology, Hull Royal Infirmary, Anlaby Road, Hull HU3 2JZ, UK. E-mail: drdbiswas@hotmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To consolidate the key features of carcinoma showing thymus-like element, including its management.

Method:

We present our experience of the difficult diagnosis and management of this rare tumour. We also present the results of an extensive literature search, documenting those aspects of the clinical picture, natural history and management of carcinoma showing thymus-like element which are relevant to head and neck surgeons.

Result:

Intrathyroidal, epithelial carcinoma showing thymus-like element is a rare, malignant tumour of the thyroid gland, with histopathological features similar to squamous cell carcinoma but a more favourable prognosis. It is usually treated surgically using a combination of total thyroidectomy and selective neck dissection, with radiotherapy and chemotherapy in selected cases.

Conclusion:

Carcinoma showing thymus-like element of the thyroid gland is a rare condition. Head and neck surgeons with a thyroid interest should be aware of this tumour, because of its close histological resemblance to other, commoner malignancies of the thyroid gland.

Keywords

CarcinomaThyroidThymus

Information

Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 11 , November 2010 , pp. 1242 - 1244
Copyright
Copyright © JLO (1984) Limited 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

Footnotes

Presented at the 13th British Academic Conference of Otolaryngology, 9th July 2009, Liverpool, UK.

References

1 Chan, JK, Rosai, J. Tumors of the neck showing thymic or related branchial pouch differentiation: a unifying concept. Hum Pathol 1991;22:349–67CrossRefGoogle ScholarPubMed
2 Chan, JKC. Tumors of the thyroid and parathyroid glands. In: Fletcher, CDM, ed. Diagnostic Histopathology of Tumors. London: Harcourt, 2000;1013–15Google Scholar
3 Miyauchi, A, Kuma, K, Matsuzuka, F, Matsubayashi, S, Kobayashi, A, Tamai, H et al. Intrathyroidal epithelial thymoma: an entity distinct from squamous cell carcinoma of the thyroid. World J Surg 1985;9:128–35CrossRefGoogle ScholarPubMed
4 Ito, Y, Miyauchi, A, Nakamura, Y, Miya, A, Kobayashi, K, Kakudo, K. Clinicopathologic significance of intrathyroidal epithelial thymoma/carcinoma showing thymus-like differentiation: a collaborative study with Member Institutes of the Japanese Society of Thyroid Surgery. Am J Clin Pathol 2007;127:230–6CrossRefGoogle ScholarPubMed
5 Ahuja, AT, Chan, ES, Allen, PW, Lau, KY, King, W, Metreweli, C. Carcinoma showing thymic like differentiation (CASTLE tumor). AJNR Am J Neuroradiol 1998;19:1225–8Google Scholar
6 Da, J, Shi, H, Lu, J. Thyroid squamous-cell carcinoma showing thymus-like element (CASTLE): a report of eight cases [in Chinese]. Zhonghua Zhong Liu Za Zhi 1999;21:303–4Google Scholar
7 Dorfman, DM, Shahsafaei, A, Miyauchi, A. Intrathyroidal epithelial thymoma (ITET)/carcinoma showing thymus-like differentiation (CASTLE) exhibits CD5 immunoreactivity: new evidence for thymic differentiation. Histopathology 1998;32:104–9CrossRefGoogle ScholarPubMed
8 Shek, TW, Luk, IS, Ng, IO, Lo, CY. Lymphoepithelioma-like carcinoma of the thyroid gland: lack of evidence of association with Epstein-Barr virus. Hum Pathol 1996;27:851–3CrossRefGoogle ScholarPubMed
9 Kusada, N, Hara, Y, Kobayashi, S, Weihua, T, Nakamura, Y, Kakudo, K et al. A case of aggressive carcinoma showing thymus-like differentiation with distant metastases. Thyroid 2005;15:1383–8CrossRefGoogle ScholarPubMed
10 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;27:927–33CrossRefGoogle ScholarPubMed
11 Piacentini, MG, Romano, F, De Fina, S, Sartori, P, Leone, EB, Rubino, B et al. Carcinoma of the neck showing thymic-like elements (CASTLE): report of a case and review of the literature. Int J Surg Pathol 2006;14:171–5CrossRefGoogle ScholarPubMed
12 Roka, S, Kornek, G, Schüller, J, Ortmann, E, Feichtinger, J, Armbruster, C. Carcinoma showing thymic-like elements – a rare malignancy of the thyroid gland. Br J Surg 2004;91:142–5CrossRefGoogle ScholarPubMed
13 Chow, SM, Chan, JK, Tse, LL, Tang, DL, Ho, CM, Law, SC. Carcinoma showing thymus-like element (CASTLE) of thyroid: combined modality treatment in 3 patients with locally advanced disease. Eur J Surg Oncol 2007;33:83–5CrossRefGoogle ScholarPubMed
14 Ng, WK, Collins, RJ, Shek, WH, Ng, IO. Cytologic diagnosis, of “CASTLE” of thyroid gland: report of a case with histologic correlation. Diagn Cytopathol 1996;15:224–73.0.CO;2-G>CrossRefGoogle ScholarPubMed
15 Kini, SR. Miscellaneous lesions of the Thyroid. In: McGough, L ed. Thyroid Cytopathology: An Atlas & Text. Philadelphia: Lippincott Williams & Wilkins, 2008;419Google Scholar