Electron microscopic analysis of an angiosarcoma of the thyroid from a non-Alpine endemic goiter region: A case report and brief review of the literature
Identifieur interne : 004240 ( Pmc/Curation ); précédent : 004239; suivant : 004241Electron microscopic analysis of an angiosarcoma of the thyroid from a non-Alpine endemic goiter region: A case report and brief review of the literature
Auteurs : Serdar Altinay [Turquie] ; Aynur Özen [Turquie] ; Esat Namal [Turquie] ; Pelin Ertürküner [Turquie]Source :
- Oncology Letters [ 1792-1074 ] ; 2014.
Abstract
Angiomatoid tumors of the thyroid gland are rare endocrine neoplasms, which exhibit an aggressive behavior. Angiosarcomas of the thyroid are generally reported from the European Alpine region and have a histogenesis that has been under debate for a number of years. The current study presents a rare case of angiosarcoma of the thyroid in a 62-year-old Turkish female. The patient had a 10-year history of goiter and was from the Black Sea region, an endemic goiter region of Turkey. The patient was not taking any medication at the time of admission and swelling had been observed on the right side of the neck throughout the previous few months. Thyroid function tests, which analyzed the levels of thyroid-stimulating hormone, thyroxine and triiodothyronine, were within the normal limits, however, the histopathological findings were consistent with an angiosarcoma of the thyroid. The patient rejected the complementary surgery and chemotherapy options, and is currently disease-free (as per the 15-month follow-up). The current study describes a case of angiosarcoma that was characterized by Weibel-Palade bodies, and light microscopy and immunohistochemical findings, as well as an endothelial origin, which was demonstrated via electron microscopy. To the best of our knowledge, this is the first reported case of angiosarcoma of the thyroid in a patient from Turkey to be validated by electron microscopy. Furthermore, this case is one of the few reported thyroid angiosarcoma cases in a non-Alpine region.
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DOI: 10.3892/ol.2014.2470
PubMed: 25289092
PubMed Central: 4186527
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<series><title level="j">Oncology Letters</title>
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<front><div type="abstract" xml:lang="en"><p>Angiomatoid tumors of the thyroid gland are rare endocrine neoplasms, which exhibit an aggressive behavior. Angiosarcomas of the thyroid are generally reported from the European Alpine region and have a histogenesis that has been under debate for a number of years. The current study presents a rare case of angiosarcoma of the thyroid in a 62-year-old Turkish female. The patient had a 10-year history of goiter and was from the Black Sea region, an endemic goiter region of Turkey. The patient was not taking any medication at the time of admission and swelling had been observed on the right side of the neck throughout the previous few months. Thyroid function tests, which analyzed the levels of thyroid-stimulating hormone, thyroxine and triiodothyronine, were within the normal limits, however, the histopathological findings were consistent with an angiosarcoma of the thyroid. The patient rejected the complementary surgery and chemotherapy options, and is currently disease-free (as per the 15-month follow-up). The current study describes a case of angiosarcoma that was characterized by Weibel-Palade bodies, and light microscopy and immunohistochemical findings, as well as an endothelial origin, which was demonstrated via electron microscopy. To the best of our knowledge, this is the first reported case of angiosarcoma of the thyroid in a patient from Turkey to be validated by electron microscopy. Furthermore, this case is one of the few reported thyroid angiosarcoma cases in a non-Alpine region.</p>
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<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Oncol Lett</journal-id>
<journal-id journal-id-type="iso-abbrev">Oncol Lett</journal-id>
<journal-id journal-id-type="publisher-id">OL</journal-id>
<journal-title-group><journal-title>Oncology Letters</journal-title>
</journal-title-group>
<issn pub-type="ppub">1792-1074</issn>
<issn pub-type="epub">1792-1082</issn>
<publisher><publisher-name>D.A. Spandidos</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">25289092</article-id>
<article-id pub-id-type="pmc">4186527</article-id>
<article-id pub-id-type="doi">10.3892/ol.2014.2470</article-id>
<article-id pub-id-type="publisher-id">ol-08-05-2117</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Articles</subject>
</subj-group>
</article-categories>
<title-group><article-title>Electron microscopic analysis of an angiosarcoma of the thyroid from a non-Alpine endemic goiter region: A case report and brief review of the literature</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>ALTINAY</surname>
<given-names>SERDAR</given-names>
</name>
<xref ref-type="aff" rid="af1-ol-08-05-2117">1</xref>
<xref ref-type="corresp" rid="c1-ol-08-05-2117"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>ÖZEN</surname>
<given-names>AYNUR</given-names>
</name>
<xref ref-type="aff" rid="af2-ol-08-05-2117">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>NAMAL</surname>
<given-names>ESAT</given-names>
</name>
<xref ref-type="aff" rid="af3-ol-08-05-2117">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>ERTÜRKÜNER</surname>
<given-names>PELIN</given-names>
</name>
<xref ref-type="aff" rid="af4-ol-08-05-2117">4</xref>
</contrib>
</contrib-group>
<aff id="af1-ol-08-05-2117"><label>1</label>
Department of Pathology, Thyroid Unit, Bağcılar Training and Education Hospital, Istanbul 34203, Turkey</aff>
<aff id="af2-ol-08-05-2117"><label>2</label>
Department of Nuclear Medicine, Bağcılar Training and Education Hospital, Istanbul 34203, Turkey</aff>
<aff id="af3-ol-08-05-2117"><label>3</label>
Department of Oncology, Bağcılar Training and Education Hospital, Istanbul 34203, Turkey</aff>
<aff id="af4-ol-08-05-2117"><label>4</label>
Department of Histology and Embryology, Medical Faculty of Cerrahpaşa, Istanbul University, Istanbul 34098, Turkey</aff>
<author-notes><corresp id="c1-ol-08-05-2117">Correspondence to: Dr Serdar Altınay, Department of Pathology, Thyroid Unit, Bağcilar Training and Education Hospital, 6 Merkez Mahallesi Mimar Sinan Caddesi, Bağcılar, Istanbul 34203, Turkey, E-mail: <email>drserdara@yahoo.com</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub"><month>11</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="epub"><day>21</day>
<month>8</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>21</day>
<month>8</month>
<year>2014</year>
</pub-date>
<pmc-comment> PMC Release delay is 0 months and 0 days and was based on the
. </pmc-comment>
<volume>8</volume>
<issue>5</issue>
<fpage>2117</fpage>
<lpage>2121</lpage>
<history><date date-type="received"><day>30</day>
<month>1</month>
<year>2014</year>
</date>
<date date-type="accepted"><day>15</day>
<month>7</month>
<year>2014</year>
</date>
</history>
<permissions><copyright-statement>Copyright © 2014, Spandidos Publications</copyright-statement>
<copyright-year>2014</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/3.0"><license-p>This is an open-access article licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License. The article may be redistributed, reproduced, and reused for non-commercial purposes, provided the original source is properly cited.</license-p>
</license>
</permissions>
<abstract><p>Angiomatoid tumors of the thyroid gland are rare endocrine neoplasms, which exhibit an aggressive behavior. Angiosarcomas of the thyroid are generally reported from the European Alpine region and have a histogenesis that has been under debate for a number of years. The current study presents a rare case of angiosarcoma of the thyroid in a 62-year-old Turkish female. The patient had a 10-year history of goiter and was from the Black Sea region, an endemic goiter region of Turkey. The patient was not taking any medication at the time of admission and swelling had been observed on the right side of the neck throughout the previous few months. Thyroid function tests, which analyzed the levels of thyroid-stimulating hormone, thyroxine and triiodothyronine, were within the normal limits, however, the histopathological findings were consistent with an angiosarcoma of the thyroid. The patient rejected the complementary surgery and chemotherapy options, and is currently disease-free (as per the 15-month follow-up). The current study describes a case of angiosarcoma that was characterized by Weibel-Palade bodies, and light microscopy and immunohistochemical findings, as well as an endothelial origin, which was demonstrated via electron microscopy. To the best of our knowledge, this is the first reported case of angiosarcoma of the thyroid in a patient from Turkey to be validated by electron microscopy. Furthermore, this case is one of the few reported thyroid angiosarcoma cases in a non-Alpine region.</p>
</abstract>
<kwd-group><kwd>thyroid angiosarcoma</kwd>
<kwd>non-Alpine</kwd>
<kwd>endemic goiter</kwd>
<kwd>CD31 antibody</kwd>
</kwd-group>
</article-meta>
</front>
<floats-group><fig id="f1-ol-08-05-2117" orientation="portrait" position="float"><label>Figure 1</label>
<caption><p>(A) Macroscopic image of thyroid angiosarcoma showing a well-encapsulated nodule that appeared to be cystic and hemorrhagic on the cut surface. Histologically, hematoxylin and eosin staining revealed a (B) peripheral rim of normal thyroid tissue and a central area of hemorrhaging (magnification, ×100) and (C) anastomosing angiomatous structures lined by the neoplastic endothelium (magnification, ×200). (D) High-power view demonstrated large atypical epithelioid tumor cells with prominent nucleoli (magnification, ×400).</p>
</caption>
<graphic xlink:href="OL-08-05-2117-g00"></graphic>
</fig>
<fig id="f2-ol-08-05-2117" orientation="portrait" position="float"><label>Figure 2</label>
<caption><p>Immunohistochemical staining showed (A) strong diffuse immunoreactivity with CD31 in the membranes of the malignant cells of vascular neoplastic channels, (B) focal strong pan-cytokeratin AE1/AE3 staining, (C) positive staining with thyroglobulin in the abortive follicles and (D) intense staining with vimentin (magnification, ×400).</p>
</caption>
<graphic xlink:href="OL-08-05-2117-g01"></graphic>
</fig>
<fig id="f3-ol-08-05-2117" orientation="portrait" position="float"><label>Figure 3</label>
<caption><p>Electron microscopy revealed oval-shaped tumor cells surrounded by continuous basal lamina. Weibel-Palade bodies (arrows) were identified in the cytoplasm of the endothelial cells (magnification, ×60,000; inset, ×40,000).</p>
</caption>
<graphic xlink:href="OL-08-05-2117-g02"></graphic>
</fig>
<fig id="f4-ol-08-05-2117" orientation="portrait" position="float"><label>Figure 4</label>
<caption><p>Postoperative positron emission tomography (PET)/computed tomography (CT) maximum intensity projection images. (A) A hypodense lesion showed peripheral minimal hypermetabolism in the right inferior jugular area, compatible with postopreative changes or tumor residue. (B) PET image revealing minimal hypermetabolism with a low fluorodeoxyglucose uptake in same area, (C) CT image and (D) fusion images of the axial cross section revealing a hypodense lesion in the area of the right inferior jugular.</p>
</caption>
<graphic xlink:href="OL-08-05-2117-g03"></graphic>
</fig>
</floats-group>
</pmc>
</record>
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