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Primary thyroid thymoma: a distinct clinicopathologic entity.

S L Asa¹, I Dardick, A W Van Nostrand

¹Department of Pathology, St. Michael's Hospital, Toronto, Ontario, Canada.

Human Pathology

|December 1, 1988

Summary

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A rare paratracheal tumor was identified as a primary thyroid thymoma, distinct from anaplastic or medullary thyroid carcinoma. This neoplasm exhibits a more benign clinical behavior, offering a new diagnostic consideration.

Area of Science:

Oncology
Pathology
Endocrinology

Background:

A 51-year-old male presented with a paratracheal tumor, 15 years post-thyroid anaplastic carcinoma resection.
Initial clinical diagnosis suggested recurrent medullary thyroid carcinoma.

Observation:

Histologic examination revealed a poorly differentiated epithelial tumor.
Immunoreactivity for keratins, carcinoembryonic antigen, and focal S-100 protein was noted.
The tumor was negative for calcitonin and thyroglobulin, ruling out medullary thyroid carcinoma.

Findings:

Ultrastructural analysis showed elongated epithelial cells with desmosomes and tonofilaments, lacking secretory granules.
Absence of amyloid confirmed by ultrastructural and histochemical methods.
The tumor's unique features and clinical behavior confirmed it as a primary thyroid thymoma.

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Implications:

This study verifies the existence of primary thyroid thymoma, a novel thyroid neoplasm.
Primary thyroid thymoma demonstrates a more benign clinical course compared to other differential diagnoses.
Recognition of this entity is crucial for accurate diagnosis and patient management.