Thyroid Gland Follicular Carcinoma

This case represents the first reported collision tumor combining thyroid PEComa and FTC, with immunohistochemistry confirming the independent origins of both tumors. The findings expand our understanding of thyroid tumor varieties and highlight the crucial role of Ultrasound and histopathology in diagnosing and managing complex thyroid tumors, serving as a valuable reference for similar cases.

It underscores the importance of extensive sampling and a multidisciplinary approach for effective management. Given the lack of standardized treatment guidelines, personalised care and close follow-up are essential, with consideration of aggressive treatment based on risk assessment.

Analytical validation of the ultrasensitive immunoassay for FNA samples was obtained for 3 matrices; matrix features and sample storage at ‒20 °C do not affect the reliability of thyroglobulin measurements. Use of a protein matrix is recommended for possible presence of samples with low analyte values.

Combined measurement of serum CEA, Tg, CT, and TSH significantly enhances the diagnostic efficacy for TC, reducing both misdiagnosis and missed diagnosis rates, and provides a reliable basis for early clinical detection and intervention.

The present study discusses differences in tumor cell morphology and their diagnostic relevance in relation to previous reports, clinical history, histopathology and molecular pathology. The observations may contribute to improving diagnostic precision in cancer-to-cancer metastasis.

High PSMA expression in differentiated thyroid cancer was associated with shorter progression-free survival and may be considered a marker of aggressiveness. Such tumors could be candidates for targeted PSMA-radioligand therapy (e.g., 177 lutetium), particularly in radioiodine-negative/refractory cases, which are difficult to treat.

P=N/A, N=90, Recruiting, Duke University | Trial completion date: Dec 2027 --> Dec 2028 | Trial primary completion date: Dec 2025 --> Apr 2028

TROP-2 showed higher sensitivity in detecting malignant lesions, whereas galectin-1 exhibits greater specificity. Combining both markers enhances the differentiation between benign and malignant lesions, thus providing valuable diagnostic insight.

Subsequent evaluation confirmed elevated serum calcitonin levels, leading to the accurate diagnosis of medullary thyroid carcinoma (MTC) confirmed by a pathologic review of the initial surgical specimen. This case highlights consideration of the potential for primary misdiagnosis in radio-iodine refractory differentiated thyroid cancer (DTC) with low serum Tg levels and emphasizes the importance of a thorough pathological review in patients with atypical presentations.

Negative PTEN immunohistochemical staining may suggest a PTEN mutation, but positive staining does not exclude a genetic alteration. PTEN gene mutations can be combined with BRAF, TERT, and TP53 alteration.

Overall, the histomorphologic, clinical, and molecular features of TFI support its classification as a distinct and benign entity from BCC. In addition, the presence of recurrent SLX4 alterations suggests that TFI are likely not reactive but rather may represent a true neoplasm.

Conclusion TROP-2 as a diagnostic marker was observed to have high specificity, which indicates that it has a promising role as an adjunct diagnostic method to the currently available methods. However, TROP-2's sensitivity is found to be moderate, which indicates that this marker cannot be used as a standalone diagnostic tool but rather in conjunction with other markers and histopathological examination.