Papillary thyroid carcinoma with fibromatosis-like stroma: a case report and review of the literature

BMC Endocr Disord. 2023 Apr 14;23(1):80. doi: 10.1186/s12902-023-01337-y.

Abstract

Background: Papillary thyroid carcinoma (PTC) is a common neoplasia with multiple variants. One of these extremely rare and poorly described variants is PTC with fibromatosis-like stroma (PTC-FMS), a peculiar entity distinguished by its predominant mesenchymal component. This paper reviews the literature, discusses the diagnostic challenges, and the clinical and surgical implications of this type of tumor which has fewer than 30 cases reported in the literature.

Case presentation: We reported a case of PTC-FMS found in a 41-year-old Italian woman, who came to our Institute with a recent growth in the form of a mass on the neck. Further immunohistochemical examination showed β-catenin aberrant staining both in the nuclei and cytoplasm of the mesenchymal cells. The patient underwent total thyroidectomy and received radioactive iodine (RAI) 2 months after surgery.

Conclusion: Given the possibility of recurrence of PTC-FMS and the ineffectiveness of RAI therapy, complete surgical resection represents the main treatment for this type of tumor. Despite the fact that the specific nature of these lesions has yet to be determined, guidelines for classical PTC should be followed.

Keywords: Desmoid tumor; Fibromatosis-like stroma; Nodular fasciitis-like stroma; Papillary thyroid carcinoma; β-catenin aberrant staining.

Publication types

  • Review
  • Case Reports

MeSH terms

  • Adult
  • Carcinoma, Papillary* / diagnosis
  • Carcinoma, Papillary* / pathology
  • Carcinoma, Papillary* / surgery
  • Female
  • Fibroma* / drug therapy
  • Fibroma* / surgery
  • Humans
  • Iodine Radioisotopes / therapeutic use
  • Thyroid Cancer, Papillary / diagnosis
  • Thyroid Cancer, Papillary / surgery
  • Thyroid Neoplasms* / diagnosis
  • Thyroid Neoplasms* / pathology
  • Thyroid Neoplasms* / surgery
  • Thyroidectomy

Substances

  • Iodine Radioisotopes