Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Endocrine Pathology
Published in: Endocrine Pathology 4/2011

01-12-2011

Poorly Differentiated Thyroid Carcinoma. Are We There Yet?

Author: Giovanni Tallini

Published in: Endocrine Pathology | Issue 4/2011

Login to get access

Abstract

The article reviews the controversial area of poorly differentiated thyroid carcinoma. Consensus criteria that define poorly differentiated thyroid carcinoma have been published in 2007. According to these, poorly differentiated thyroid carcinoma is a distinct histotype and the term “poorly differentiated” should not be used as a synonym for high-grade thyroid cancer. Data in the literature show that tumor necrosis and high mitotic activity, but not growth pattern or histologic subtype, are prognostic markers for thyroid tumors. This underscores the importance of grading to identify thyroid carcinomas that behave aggressively. The issue of grading versus typing thyroid tumors is discussed.
Literature
1.
Rosai J. Poorly differentiated carcinomas of the thyroid: introduction to the issue, its landmarks, and clinical impact. Endocr Pathol 15:293–296, 2004.PubMedCrossRef
2.
Volante M, Collini P, Nikiforov YE, et al. Poorly differentiated thyroid carcinoma: the Turin proposal for the use of uniform diagnostic criteria and an algorithmic diagnostic approach. Am J Surg Pathol 31:1256–1264, 2007.PubMedCrossRef
3.
Carcangiu ML, Zampi G, Rosai J. Poorly differentiated (“insular”) thyroid carcinoma. A reinterpretation of Langhans' “wuchernde Struma”. Am J Surg Pathol 8:655–668, 1984PubMedCrossRef
4.
Sakamoto A, Kasai N, Sugano H. Poorly differentiated carcinoma of the thyroid. A clinicopathologic entity for a high-risk group of papillary and follicular carcinomas. Cancer 52:1849–1855, 1983.PubMedCrossRef
5.
Sobrinho-Simoes M, Nesland JM, Johannessen JV. Columnar-cell carcinoma; another variant of poorly differentiated carcinoma of the thyroid. Am J Clin Pathol 89:264–267, 1988.PubMed
6.
Mizumani Y, Nakajima H, Annen Y, et al. Mucin-producing poorly differentiated adenocarcinoma of the thyroid. A case report. Pathol Res Pract 189:608–611, 1993.CrossRef
7.
Papotti M, Botto Micca F, Favero A, et al. Poorly differentiated thyroid carcinomas with primordial cell component: A group of aggressive lesions sharing insular, trabecular, and solid pattern. Am J Surg Pathol 17:291–301, 1993PubMedCrossRef
8.
Pilotti S, Collini P, Manzari A, et al. Poorly differentiated forms of papillary thyroid carcinoma: distinctive entities or morphological patterns? Semin Diagn Pathol 12:249–255, 1995.PubMed
9.
Papotti M, Torchio B, Grassi L, et al. Poorly differentiated oxyphilic (Hürthle cell) carcinomas of the thyroid. Am J Surg Pathol 20:686–694, 1996.PubMedCrossRef
10.
Pilotti S, Collini P, Mariani L, et al. Insular carcinoma: a distinct de novo entity among follicular carcinomas of the thyroid gland. Am J Surg Pathol 21:1466–1473, 1997.PubMedCrossRef
11.
Decaussin M, Bernard MH, Adeleine P, et al. Thyroid carcinomas with distant metastases: a review of 111 cases with emphasis on the prognostic significance of an insular component. Am J Surg Pathol 26:1007–1015, 2002.PubMedCrossRef
12.
Sobrinho-Simoes M, Sambade C, Fonseca E, et al. Poorly differentiated carcinomas of the thyroid gland: a review of the clinicopathologic features of a series of 28 cases of a heterogeneous, clinically aggressive group of thyroid tumors. Int J Surg Pathol 10:123–132, 2002.PubMedCrossRef
13.
Sobrinho Simoes M, Albores-Saavedra J, Tallini G, et al. Poorly differentiated thyroid carcinoma. World Health Organization Classification of Tumors-Pathology and Genetics, Tumors of Endocrine Organs, IARC Press, Lyon (France), 2004, pp.73-76
14.
Asioli S, Erickson LA, Righi A, et al. Poorly differentiated carcinoma of the thyroid: validation of the Turin proposal and analysis of IMP3 expression. Mod Pathol 23:1269–1278, 2010.PubMedCrossRef
15.
Tallini G, Garcia-Rostan G, Herrero A, et al. Downregulation of p27Kip1 and Ki67/Mib1 labeling index support the classification of thyroid carcinoma into prognostically relevant categories. Am J Surg Pathol 23:678–685, 1999.PubMedCrossRef
16.
Pilotti S, Collini P, Del Bo R, et al. A novel panel of antibodies that segregates immunocytochemically poorly differentiated carcinoma from undifferentiated carcinoma of the thyroid gland. Am J Surg Pathol 18:1054–1064, 1994.PubMedCrossRef
17.
Ghossein RA, Leboeuf R, Patel KN, et al. Tall cell variant of papillary thyroid carcinoma without extrathyroid extension: biologic behavior and clinical implications. Thyroid 17:655–661, 2007.PubMedCrossRef
18.
Rivera M, Ghossein RA, Schoder H, et al. Histopathologic characterization of radioactive iodine-refractory fluorodeoxyglucose-positron emission tomography-positive thyroid carcinoma. Cancer 113:48–56, 2008.PubMedCrossRef
19.
Piana S, Frasoldati A, Di Felice E, et al. Encapsulated well-differentiated follicular-patterned thyroid carcinomas do not play a significant role in the fatality rates from thyroid carcinoma. Am J Surg Pathol 34:868–72, 2010.PubMedCrossRef
20.
Hiltzik D, Carlson DL, Tuttle RM, et al. Poorly differentiated thyroid carcinomas defined on the basis of mitosis and necrosis: a clinicopathologic study of 58 patients. Cancer 106:1286–95, 2006.PubMedCrossRef
21.
Broders AC. Squamous-cell Epithelioma of the skin: A study of 256 Cases. Ann Surg 73:141–160, 1921.PubMedCrossRef
22.
Akslen LA, Livolsi VA. Prognostic significance of histologic grading compared subclassification of papillary thyroid carcinoma. Cancer 88:1902–1908, 2000.PubMedCrossRef
23.
Akslen LA, LiVolsi V. Poorly differentiated thyroid carcinoma—it is important (letter to the editor). Am J Surg Pathol 24:310, 2000.PubMedCrossRef
24.
Volante M, Papotti M. Poorly differentiated thyroid carcinoma: 5 years after the 2004 WHO classification of endocrine tumours. Endocr Pathol 21:1–6, 2010.PubMedCrossRef
25.
Rivera M, Ricarte-Filho J, Patel S, et al. Encapsulated thyroid tumors of follicular cell origin with high grade features (high mitotic rate/tumor necrosis): a clinicopathologic and molecular study. Hum Pathol 41:172–180, 2010.PubMedCrossRef
26.
Sobrinho-Simões M. Hail to the histologic grading of papillary thyroid carcinoma? Cancer 88:1766–1768, 2000.PubMedCrossRef
27.
Bertucci F, Orsetti B, Nègre V, et al. Lobular and ductal carcinomas of the breast have distinct genomic and expression profiles. Oncogene 27:5359–5372, 2008.PubMedCrossRef
28.
Kwak EL, Bang YJ, Camidge DR, et al. Anaplastic lymphoma kinase inhibition in non-small cell lung cancer. N Engl J Med 363:1693–1703, 2010.PubMedCrossRef
29.
Kondo T, Ezzat S, Asa SL. Pathogenetic mechanisms in thyroid follicular-cell neoplasia. Nat Rev Cancer 6:292–306, 2006.PubMedCrossRef
30.
Volante M, Rapa I, Gandhi M, et al. RAS mutations are the predominant molecular alteration in poorly differentiated thyroid carcinomas and bear prognostic impact. J Clin Endocrinol Metab 94:4735–4741, 2009.PubMedCrossRef
31.
Nikiforova MN, Kimura ET, Gandhi M, et al. BRAF mutations in thyroid tumors are restricted to papillary carcinomas and anaplastic or poorly differentiated carcinomas arising from papillary carcinomas. J Clin Endocrinol Metab 88:5399–5404, 2003.PubMedCrossRef
32.
Ricarte-Filho JC, Ryder M, Chitale DA, et al. Mutational profile of advanced primary and metastatic radioactive iodine-refractory thyroid cancers reveals distinct pathogenetic roles for BRAF, PIK3CA, and AKT1. Cancer Res 69:4885–4893, 2009.PubMedCrossRef
33.
Guillou L, Coindre JM, Bonichon F, et al. Comparative study of the National Cancer Institute and French Federation of Cancer Centers Sarcoma Group grading systems in a population of 410 patients with soft tissue sarcoma. J Clin Oncol 15:350 – 362, 1997.PubMed
Metadata
Title
Poorly Differentiated Thyroid Carcinoma. Are We There Yet?
Author
Giovanni Tallini
Publication date
01-12-2011
Publisher
Springer US
Published in
Endocrine Pathology / Issue 4/2011
Print ISSN: 1046-3976
Electronic ISSN: 1559-0097
DOI
https://doi.org/10.1007/s12022-011-9176-5

Other articles of this Issue 4/2011

Endocrine Pathology 4/2011 Go to the issue

Report

Images in Endocrine Pathology: Lipoadenoma-like Cystic Epithelial Lesion in the Lateral Neck

OriginalPaper

Unique Growth Pattern in Papillary Carcinoma of the Thyroid Gland Mimicking Adenoid Cystic Carcinoma

BriefCommunication

A Silent Follicle-Stimulating Hormone-Producing Pituitary Adenoma in a Teenage Male

Announcement

Dr. Bernd W. Scheithauer

BriefCommunication

Is Adrenal Ovarian Thecal Metaplasia a Misnomer? Report of Three Cases of Radial Scar-Like Spindle Cell Myofibroblastic Nodule of the Adrenal Gland

BriefCommunication

Sellar Glomangioma
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits