Table 1.
Clinicopathologic Features of 58 Patients Harboring Fatal Non-Anaplastic Follicular Cell–Derived Thyroid Carcinomas
| N (column %) | |
|---|---|
| N | 58 |
| Age (years), median (range) | 65 (28–89) |
| Tumor size (cm), median (range) | 4.05 (0.4–12.0) |
| Sex | |
| Female | 30 (52%) |
| Male | 28 (48%) |
| Classification of primary thyroid carcinoma using the MSKCC criteria for PDTC | |
| PDTC | 33 (57%) |
| Hürthle cell carcinoma | 4 (7%) |
| Tall-cell variant PTC | 14 (24%) |
| Classical variant PTC | 2 (3%) |
| Follicular variant PTC | 2 (3%) |
| PTC microcarcinoma | 3 (5%) |
| Classification of primary thyroid carcinoma using the Turin proposal criteria for PDTC | |
| PDTC | 15 (26%) |
| Follicular carcinoma | 1 (2%) |
| Hürthle cell carcinoma | 6 (10%) |
| Tall-cell variant PTC | 20 (34%) |
| Columnar variant PTC | 4 (7%) |
| Solid variant PTC | 1 (2%) |
| Classical variant PTC | 5 (9%) |
| Follicular variant PTC | 3 (5%) |
| PTC microcarcinoma | 3 (5%) |
| Carcinoma of the highest histologic grade in the primary resection (thyroid and neck lymph nodes) using the MSKCC criteria for PDTCa | |
| PDTC | 36 (62%) |
| Hürthle cell carcinoma | 4 (7%) |
| Tall-cell variant PTC | 14 (24%) |
| Classical variant PTC | 1 (2%) |
| Follicular variant PTC | 2 (3%) |
| Solid variant PTC | 1 (2%) |
| Mitotic index (10 HPFs, 400×) | |
| ≥5/10 HPFs | 25 (43%) |
| 0–4/10 HPFs | 33 (57%) |
| Tumor necrosis | |
| Extensive | 10 (17%) |
| Focal | 11 (19%) |
| None | 37 (64%) |
| Tumor encapsulation | |
| Partially encapsulated or non-encapsulated | 47 (81%) |
| Encapsulated | 10 (17%) |
| NA | 1 (2%) |
| Capsular invasion in encapsulated carcinomas (n = 10) | |
| Extensive | 6 (60%) |
| Focal | 4 (40%) |
| Vascular invasion | |
| Extensive | 21 (36%) |
| Focal | 10 (17%) |
| None | 25 (43%) |
| NA | 2 (3%) |
| Margin status | |
| Positive | 29 (50%) |
| Negative | 27 (47%) |
| N/A | 2 (3%) |
| Gross extension beyond the thyroid | |
| Presentb | 36 (62%) |
| Absent | 22 (38%) |
| Microscopic extrathyroidal extension of the dominant carcinoma | |
| Extensive | 40 (69%) |
| Focal | 6 (11%) |
| None | 10 (18%) |
| N/A | 2 (4%) |
| Metastasis to neck lymph nodes in patients who underwent lymph node sampling at initial surgery (n = 44) | |
| Present | 35 (80%) |
| Absent | 9 (20%) |
| Metastasis to ≥5 neck lymph nodes (n = 44) | |
| Present | 19 (43%) |
| Absent | 25 (57%) |
| ENE in 35 patients with positive lymph nodes at the initial surgery | |
| Present | 23 (66%) |
| Absent | 12 (34%) |
| Distant metastasis | |
| Present at initial presentation | 27 (47%) |
| Developed during clinical follow-up | 28 (48%) |
| Absentc | 3 (5%) |
| Mode of death | |
| Distant metastasis | 51 (88%) |
| Distant metastasis and locoregional recurrence | 3 (5%) |
| Unknown | 1 (2%) |
| Locoregional recurrence | 3 (5%) |
a
The carcinoma of the higher histological grade was documented when the histology of the carcinoma from the thyroid and from the neck lymph nodes were not identical.
b
One patient with tall-cell variant PTC had gross ENE. The remaining patients had gross ETE.
c
All three patients were diagnosed with tall-cell variant PTC and died due to unresectable locoregional recurrence.
PTC, papillary thyroid carcinoma; PDTC, poorly differentiated thyroid carcinoma; HPFs, high power fields; ENE, extranodal extension; NA, not available/not applicable; ETE, extrathyroidal extension.