Insular variant of poorly differentiated thyroid carcinoma

Area of Science:

• Endocrinology
• Oncology
• Pathology

Background:

• Poorly differentiated thyroid carcinoma (PDTC) represents a rare and aggressive epithelial thyroid cancer.
• It is diagnostically challenging, often falling between differentiated and anaplastic thyroid carcinomas.
• PDTC is characterized by increased aggressiveness, local recurrence, distant metastases, and higher mortality rates.

Purpose of the Study:

• To present a case of the insular variant of PDTC.
• To review the literature on the diagnosis, natural history, and treatment of PDTC.
• To discuss advanced imaging modalities for PDTC surveillance.

Main Methods:

• Case presentation of a patient with insular PDTC.
• Comprehensive review of English-language literature on PDTC from 1970 to the present.
• Analysis of diagnostic and therapeutic strategies, including imaging.

Main Results:

• PDTC exhibits aggressive behavior, including propensity for recurrence and metastasis.
• Aggressive management, including total thyroidectomy and radioactive iodine ablation, is recommended.
• The utility of chemotherapy remains unclear, and advanced imaging plays a role in surveillance.

Conclusions:

• PDTC is an aggressive thyroid malignancy that may not be definitively diagnosed by fine-needle aspiration.
• Standard treatment involves total thyroidectomy, neck dissection, and high-dose radioactive iodine remnant ablation.
• Radioiodine I 131 whole body scanning is a primary surveillance tool, supplemented by other imaging as needed.