Abstract
To describe a patient with a diffuse sclerosing variant of papillary (DSVP) thyroid cancer and to summarize the reported clinical manifestations and treatment of other patients with this malignant tumor. We reviewed the pathologic findings in a 14-year-old girl, who had survived for 19 years after treatment of a presumed undifferentiated thyroid cancer. When reassessment revealed histologic features of DSVP cancer, we reviewed the case reports of this type of malignant lesion identified from a MEDLINE search of articles published between 1985 and 1995. Review of the pathologic features showed a diffuse tumor in the thyroid gland without an identifiable mass and extensive bilateral lymph node metastatic lesions. Histologic examination disclosed pronounced fibrosis, numerous psammoma bodies, primarily a solid growth pattern, lymphocytic infiltration, and extensive invasion of lymphatic spaces. The nuclear features were characteristic of papillary carcinoma. Review of 63 cases of DSVP cancer indicated that this variant accounted for 0.2 to 5.7% of papillary cancer, affected primarily young women, and usually manifested with diffuse involvement of one or both thyroid lobes. Thyroid antibodies were frequently detected in the serum. ...Continue Reading
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