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01-04-2021 | Metastasis | Review

Hobnail variant of papillary thyroid carcinoma: a systematic review and meta-analysis

Authors: Lane B. Donaldson, Flora Yan, Patrick F. Morgan, John M. Kaczmar, Jyotika K. Fernandes, Shaun A. Nguyen, Rachel L. Jester, Terry A. Day

Published in: Endocrine | Issue 1/2021

Abstract

Objective

The hobnail variant of papillary thyroid carcinoma (HVPTC) has emerged as a rare and aggressive variant of papillary thyroid carcinoma (PTC). We aim to determine the prevalence and clinicopathologic factors of HVPTC.

Methods

A systematic review of the literature for studies examining HVPTC was performed. Four databases (PubMed, Scopus, OVID, Cochrane library) were queried from inception of databases through March 20th, 2020.

Results

Sixteen studies with 124 cases of HVPTC were included. The mean age for all patients was 52.3 years. HVPTC had a prevalence of 1.08% out of all PTC cases, with a mean tumor size of 3.1 cm. In 62% and 50% of cases, lymphovascular invasion and extrathyroidal extension were present, respectively. Follow-up data, with a mean of 49.9 months, revealed a 66% rate of lymph node metastasis and 23% rate of distant metastasis. Tumors with ≥30% hobnail morphology had a 2.6-fold increased odds of developing lymph node metastasis compared with <30% hobnail morphology, however did not differ in rates of distant metastasis. Patients ≥55 years old had a 4.5-fold increased odds of distant metastasis and a 4.7-fold increased odds of lymphovascular invasion over patients <55.

Conclusions

High rates of locoregional and distant disease as well as high-risk pathological factors reveal the aggressive nature of HVPTC. Diagnostic criteria regarding percentage of hobnail morphology requires further refinement. Further studies are warranted in order to better understand how recognition of this high-risk variant impacts clinical treatment.

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Title: Hobnail variant of papillary thyroid carcinoma: a systematic review and meta-analysis
Authors: Lane B. Donaldson
Flora Yan
Patrick F. Morgan
John M. Kaczmar
Jyotika K. Fernandes
Shaun A. Nguyen
Rachel L. Jester
Terry A. Day
Publication date: 01-04-2021
Publisher: Springer US
Keywords: Metastasis
Thyroid Cancer
Thyroid Cancer
Thyroid Cancer
Published in: Endocrine / Issue 1/2021
Print ISSN: 1355-008X
Electronic ISSN: 1559-0100
DOI: https://doi.org/10.1007/s12020-020-02505-z

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