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Cervical chordoma masquerading as a thyroid neoplasm: a case report
Anjali Saqi1, Virginia Livolsi, Susan J Mandel
1Department of Pathology, New York Presbyterian Hospital, Columbia-Presbyterian Medial Center, New York, 10032, USA. aas177@columbia.edu
Diagnostic Cytopathology
|April 15, 2005
Summary
Chordomas near the thyroid can mimic thyroid cancer due to similar cell features and thyroglobulin staining. Careful histological review is crucial to distinguish these rare spinal neoplasms from actual thyroid malignancies.
Area of Science:
- Oncology
- Pathology
- Endocrinology
Background:
- Chordomas are rare spinal tumors originating from notochordal remnants.
- Their location along the craniospinal axis, particularly the cervical spine, can lead to diagnostic challenges.
- Proximity to the thyroid gland increases the risk of misdiagnosis.
Observation:
- A paraspinal mass adjacent to the thyroid presented with features mimicking thyroid carcinoma.
- The mass showed intranuclear inclusions, oncocytic cytoplasm, and pleomorphism, expressing thyroglobulin.
- Fine-needle aspirates (FNAs) suggested a thyroid malignancy.
Findings:
- Histological examination confirmed the mass as a chordoma with invasion into surrounding soft tissues.
- The tumor cells expressed thyroglobulin, leading to potential false-positive staining in FNAs.
- The chordoma's appearance mimicked papillary, oncocytic, and anaplastic thyroid carcinomas.
Implications:
- Chordoma should be considered in the differential diagnosis of thyroid neoplasms, especially those in the cervical region.
- Thyroglobulin staining in FNAs of paraspinal masses requires cautious interpretation to avoid misdiagnosis.
- Accurate diagnosis is essential for appropriate treatment and management of these rare tumors.