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 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Head and Neck Pathology
Published in: Head and Neck Pathology 4/2019

01-12-2019 | Original Paper

Thyroid Gland Solitary Fibrous Tumor: Report of 3 Cases and a Comprehensive Review of the Literature

Authors: Lester D. R. Thompson, Christina Wei, Lisa M. Rooper, Sean K. Lau

Published in: Head and Neck Pathology | Issue 4/2019

Login to get access

Abstract

Solitary fibrous tumors of the thyroid gland are exceptionally rare. In order to further characterize the clinical and pathologic features of solitary fibrous tumor arising at this anatomic site, three cases of thyroid gland solitary fibrous tumor were analyzed in conjunction with 35 cases compiled from the English literature. Thyroid gland solitary fibrous tumors showed an equal sex distribution with a mean age at presentation of 54.4 years (range, 28–88 years). The patients typically presented with an asymptomatic, slow growing neck mass. Microscopically, the tumors were characterized by cytologically bland spindle cells with patternless growth, hypocellular and hypercellular areas, variable amounts of collagen, and ectatic, branching blood vessels. Two previous reported tumors were considered to be histologically malignant on the basis of increased mitotic activity, profound pleomorphism and tumor necrosis. Immunohistochemically, the tumor cells are variably positive with CD34, bcl-2, and CD99. STAT6 immunohistochemistry, performed on the current cases, demonstrated a strong, diffuse nuclear expression in all tumors. Among 26 patients with available follow up data (mean 47.3 months), one developed local recurrence and distant metastasis. Solitary fibrous tumors occurring in the thyroid gland are uncommon, but can be reliably diagnosed based on the presence of characteristic morphologic features as well as immunohistochemical expression of STAT6 and CD34. The majority of thyroid gland solitary fibrous tumors have exhibited an indolent clinical course, however experience is limited. The rare potential for aggressive clinical behavior requires clinical surveillance.
Literature
1.
Chmielecki J, Crago AM, Rosenberg M, O’Connor R, Walker SR, Ambrogio L, et al. Whole-exome sequencing identifies a recurrent NAB2-STAT6 fusion in solitary fibrous tumors. Nat Genet. 2013;45(2):131–2.PubMedPubMedCentral
2.
Robinson DR, Wu YM, Kalyana-Sundaram S, Cao X, Lonigro RJ, Sung YS, et al. Identification of recurrent NAB2-STAT6 gene fusions in solitary fibrous tumor by integrative sequencing. Nat Genet. 2013;45(2):180–5.PubMedPubMedCentral
3.
Mohajeri A, Tayebwa J, Collin A, Nilsson J, Magnusson L, von Steyern FV, et al. Comprehensive genetic analysis identifies a pathognomonic NAB2/STAT6 fusion gene, nonrandom secondary genomic imbalances, and a characteristic gene expression profile in solitary fibrous tumor. Genes Chromosomes Cancer. 2013;52(10):873–86.PubMed
4.
Doyle LA, Vivero M, Fletcher CD, Mertens F, Hornick JL. Nuclear expression of STAT6 distinguishes solitary fibrous tumor from histologic mimics. Mod Pathol. 2014;27(3):390–5.PubMed
5.
Yoshida A, Tsuta K, Ohno M, Yoshida M, Narita Y, Kawai A, et al. STAT6 immunohistochemistry is helpful in the diagnosis of solitary fibrous tumors. Am J Surg Pathol. 2014;38(4):552–9.PubMed
6.
Demicco EG, Harms PW, Patel RM, Smith SC, Ingram D, Torres K, et al. Extensive survey of STAT6 expression in a large series of mesenchymal tumors. Am J Clin Pathol. 2015;143(5):672–82.PubMedPubMedCentral
7.
Cheah AL, Billings SD, Goldblum JR, Carver P, Tanas MZ, Rubin BP. STAT6 rabbit monoclonal antibody is a robust diagnostic tool for the distinction of solitary fibrous tumour from its mimics. Pathology. 2014;46(5):389–95.PubMed
8.
Koelsche C, Schweizer L, Renner M, Warth A, Jones DT, Sahm F, et al. Nuclear relocation of STAT6 reliably predicts NAB2-STAT6 fusion for the diagnosis of solitary fibrous tumour. Histopathology. 2014;65(5):613–22.PubMed
9.
Cox DP, Daniels T, Jordan RC. Solitary fibrous tumor of the head and neck. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;110(1):79–84.PubMed
10.
Kao YC, Lin PC, Yen SL, Huang SC, Tsai JW, Li CF, et al. Clinicopathological and genetic heterogeneity of the head and neck solitary fibrous tumours: a comparative histological, immunohistochemical and molecular study of 36 cases. Histopathology. 2016;68(4):492–501.PubMed
11.
Kunzel J, Hainz M, Ziebart T, Pitz S, Ihler F, Strieth S, et al. Head and neck solitary fibrous tumors: a rare and challenging entity. Eur Arch Otorhinolaryngol. 2016;273(6):1589–98.PubMed
12.
Ganly I, Patel SG, Stambuk HE, Coleman M, Ghossein R, Carlson D, et al. Solitary fibrous tumors of the head and neck: a clinicopathologic and radiologic review. Arch Otolaryngol Head Neck Surg. 2006;132(5):517–25.PubMed
13.
Bowe SN, Wakely PE Jr, Ozer E. Head and neck solitary fibrous tumors: diagnostic and therapeutic challenges. Laryngoscope. 2012;122(8):1748–55.PubMed
14.
Yang XJ, Zheng JW, Ye WM, Wang YA, Zhu HG, Wang LZ, et al. Malignant solitary fibrous tumors of the head and neck: a clinicopathological study of nine consecutive patients. Oral Oncol. 2009;45(8):678–82.PubMed
15.
Smith SC, Gooding WE, Elkins M, Patel RM, Harms PW, McDaniel AS, et al. Solitary fibrous tumors of the head and neck: a multi-institutional clinicopathologic study. Am J Surg Pathol. 2017;41(12):1642–56.PubMedPubMedCentral
16.
Brunnemann RB, Ro JY, Ordonez NG, Mooney J, El-Naggar AK, Ayala AG. Extrapleural solitary fibrous tumor: a clinicopathologic study of 24 cases. Mod Pathol. 1999;12(11):1034–42.PubMed
17.
Santeusanio G, Schiaroli S, Ortenzi A, Mule A, Perrone G, Fadda G. Solitary fibrous tumour of thyroid: report of two cases with immunohistochemical features and literature review. Head Neck Pathol. 2008;2(3):231–5.PubMedPubMedCentral
18.
Parwani AV, Galindo R, Steinberg DM, Zeiger MA, Westra WH, Ali SZ. Solitary fibrous tumor of the thyroid: cytopathologic findings and differential diagnosis. Diagn Cytopathol. 2003;28(4):213–6.PubMed
19.
Cameselle-Teijeiro J, Manuel Lopes J, Villanueva JP, Gil-Gil P, Sobrinho-Simoes M. Lipomatous haemangiopericytoma (adipocytic variant of solitary fibrous tumour) of the thyroid. Histopathology. 2003;43:406–8. England.PubMed
20.
Kie JH, Kim JY, Park YN, Lee MK, Yang WI, Park JS. Solitary fibrous tumour of the thyroid. Histopathology. 1997;30(4):365–8.PubMed
21.
Deshmukh NS, Mangham DC, Warfield AT, Watkinson JC. Solitary fibrous tumour of the thyroid gland. J Laryngol Otol. 2001;115(11):940–2.PubMed
22.
Bohorquez CL, Gonzalez-Campora R, Loscertales MC, Escudero AG, Mezquita JC. Solitary fibrous tumor of the thyroid with capsular invasion. Pathol Res Pract. 2003;199(10):687–90.PubMed
23.
Song Z, Yu C, Song X, Wei L, Liu A. Primary solitary fibrous tumor of the thyroid—report of a case and review of the literature. J Cancer. 2011;2:206–9.PubMedPubMedCentral
24.
Cameselle-Teijeiro J, Varela-Duran J, Fonseca E, Villanueva JP, Sobrinho-Simoes M. Solitary fibrous tumor of the thyroid. Am J Clin Pathol. 1994;101(4):535–8.PubMed
25.
Tanahashi J, Kashima K, Daa T, Kondoh Y, Suzuki M, Kerakawauchi H, et al. Solitary fibrous tumor of the thyroid gland: report of two cases and review of the literature. Pathol Int. 2006;56(8):471–7.PubMed
26.
Farrag TY, Micchelli S, Tufano RP. Solitary fibrous tumor of the thyroid gland. Laryngoscope. 2009;119(12):2306–8.PubMed
27.
Papi G, Corrado S, Ruggiero C, Livolsi VA. Solitary fibrous tumor of the thyroid gland associated with papillary thyroid carcinoma. Thyroid. 2006;16(3):319–20.PubMed
28.
Rodriguez I, Ayala E, Caballero C, De Miguel C, Matias-Guiu X, Cubilla AL, et al. Solitary fibrous tumor of the thyroid gland: report of seven cases. Am J Surg Pathol. 2001;25(11):1424–8.PubMed
29.
Taccagni G, Sambade C, Nesland J, Terreni MR, Sobrinho-Simoes M. Solitary fibrous tumour of the thyroid: clinicopathological, immunohistochemical and ultrastructural study of three cases. Virchows Arch A Pathol Anat Histopathol. 1993;422(6):491–7.PubMed
30.
Vaziri M, Molanaei S, Tamannaei Z. Solitary fibrous tumor of the intrathoracic goiter. Med J Islam Repub Iran. 2014;28:51.PubMedPubMedCentral
31.
Boonlorm N. Solitary fibrous tumor of thyroid gland: a case report. Bull Dep Med Serv. 2014;39(2):133–41.
32.
Verdi D, Pennelli G, Pelizzo MR, Toniato A. Solitary fibrous tumor of the thyroid gland: a report of two cases with an analysis of their clinical and pathological features. Endocr Pathol. 2011;22(3):165–9.PubMed
33.
Lin MW, Wu CT, Lee YH, Chang YL. Intrathoracic thyroid solitary fibrous tumor presenting with respiratory failure. Ann Thorac Cardiovasc Surg. 2014;20:427–9.PubMed
34.
Mizuuchi Y, Yamamoto H, Nakamura K, Shirahane K, Souzaki M, Tanaka M, et al. Solitary fibrous tumor of the thyroid gland. Med Mol Morphol. 2014;47(2):117–22.PubMed
35.
Alves Filho W, Mahmoud RR, Ramos DM, Araujo-Filho VJ, Lima PP, Cernea CR, et al. Malignant solitary fibrous tumor of the thyroid: a case-report and review of the literature. Arq Bras Endocrinol Metabol. 2014;58(4):402–6.PubMed
36.
Babouk NL. Solitary fibrous tumor of the thyroid gland. Saudi Med J. 2004;25(6):805–7.PubMed
37.
Larsen SR, Godballe C, Krogdahl A. Solitary fibrous tumor arising in an intrathoracic goiter. Thyroid. 2010;20(4):435–7.PubMed
38.
Ning S, Song X, Xiang L, Chen Y, Cheng Y, Chen H. Malignant solitary fibrous tumor of the thyroid gland: report of a case and review of the literature. Diagn Cytopathol. 2011;39(9):694–9.PubMed
39.
Cameselle-Teijeiro J. Uncommon tumors of the thyroid gland. Int J Surg Pathol. 2010;18(3 Suppl):205s–8s.PubMed
40.
Matoso A, Easley SE, Mangray S, Jacob R, DeLellis RA. Spindle cell foci in the thyroid gland: an immunohistochemical analysis. Appl Immunohistochem Mol Morphol. 2011;19(5):400–7.PubMed
41.
Vergilio J, Baloch ZW, LiVolsi VA. Spindle cell metaplasia of the thyroid arising in association with papillary carcinoma and follicular adenoma. Am J Clin Pathol. 2002;117(2):199–204.PubMed
42.
Corrado S, Corsello SM, Maiorana A, Rossi ED, Pontecorvi A, Fadda G, et al. Papillary thyroid carcinoma with predominant spindle cell component: report of two rare cases and discussion on the differential diagnosis with other spindled thyroid neoplasm. Endocr Pathol. 2014;25(3):307–14.PubMed
43.
Takada N, Hirokawa M, Ito M, Ito A, Suzuki A, Higuchi M, et al. Papillary thyroid carcinoma with desmoid-type fibromatosis: a clinical, pathological, and immunohistochemical study of 14 cases. Endocr J. 2017;64(10):1017–23.PubMed
44.
Rebecchini C, Nobile A, Piana S, Sarro R, Bisig B, Gerasimos SP, et al. Papillary thyroid carcinoma with nodular fasciitis-like stroma and beta-catenin mutations should be renamed papillary thyroid carcinoma with desmoid-type fibromatosis. Mod Pathol. 2017;30(2):236–45.PubMed
45.
Ng TL, Gown AM, Barry TS, Cheang MC, Chan AK, Turbin DA, et al. Nuclear beta-catenin in mesenchymal tumors. Mod Pathol. 2005;18(1):68–74.PubMed
46.
Rakheja D, Molberg KH, Roberts CA, Jaiswal VR. Immunohistochemical expression of beta-catenin in solitary fibrous tumors. Arch Pathol Lab Med. 2005;129(6):776–9.PubMed
47.
Wan SK, Chan JK, Tang SK. Paucicellular variant of anaplastic thyroid carcinoma. A mimic of Reidel’s thyroiditis. Am J Clin Pathol. 1996;105(4):388–93.PubMed
48.
Canos JC, Serrano A, Matias-Guiu X. Paucicellular variant of anaplastic thyroid carcinoma: report of two cases. Endocr Pathol. 2001;12(2):157–61.PubMed
49.
Chetty R, Goetsch S, Nayler S, Cooper K. Spindle epithelial tumour with thymus-like element (SETTLE): the predominantly monophasic variant. Histopathology. 1998;33(1):71–4.PubMed
50.
Lee FY, Wen MC, Jan YJ, Wang J. The predominant monophasic variant of spindle epithelial tumour with thymus-like differentiation (SETTLE) of neck soft tissue with late pulmonary metastasis. Pathology. 2010;42(2):188–90.PubMed
51.
Folpe AL, Lloyd RV, Bacchi CE, Rosai J. Spindle epithelial tumor with thymus-like differentiation: a morphologic, immunohistochemical, and molecular genetic study of 11 cases. Am J Surg Pathol. 2009;33(8):1179–86.PubMed
52.
Thompson LD, Wenig BM, Adair CF, Shmookler BM, Heffess CS. Primary smooth muscle tumors of the thyroid gland. Cancer. 1997;79(3):579–87.PubMed
53.
Kandil E, Abdel Khalek M, Abdullah O, Dali D, Faruqui S, Khan A, et al. Primary peripheral nerve sheath tumors of the thyroid gland. Thyroid. 2010;20(6):583–6.PubMed
54.
Thompson LD, Wenig BM, Adair CF, Heffess CS. Peripheral nerve sheath tumors of the thyroid gland: a series of four cases and a review of the literature. Endocr Pathol. 1996;7(4):309–18.PubMed
55.
Boudin L, Fakhry N, Chetaille B, Perrot D, Nguyen AT, Daidj N, et al. Primary synovial sarcoma of the thyroid gland: case report and review of the literature. Case Rep Oncol. 2014;7(1):6–13.PubMedPubMedCentral
56.
Fletcher CDM, Bridge JA, Lee J-C. Extrapleural solitary fibrous tumour. In: Fletcher CDM, Bridge JA, Hogendoorn PCW, Mertens F, editors. WHO classification of tumours of soft tissue and bone. Lyon: IARC; 2013. pp. 80–2.
57.
Gholami S, Cassidy MR, Kirane A, Kuk D, Zanchelli B, Antonescu CR, et al. Size and location are the most important risk factors for malignant behavior in resected solitary fibrous tumors. Ann Surg Oncol. 2017;24(13):3865–71.PubMed
58.
Salas S, Resseguier N, Blay JY, Le Cesne A, Italiano A, Chevreau C, et al. Prediction of local and metastatic recurrence in solitary fibrous tumor: construction of a risk calculator in a multicenter cohort from the French sarcoma group (FSG) database. Ann Oncol. 2017;28(8):1979–87.PubMed
59.
Demicco EG, Wagner MJ, Maki RG, Gupta V, Iofin I, Lazar AJ, et al. Risk assessment in solitary fibrous tumors: validation and refinement of a risk stratification model. Mod Pathol. 2017;30(10):1433–42.PubMed
60.
Pasquali S, Gronchi A, Strauss D, Bonvalot S, Jeys L, Stacchiotti S, et al. Resectable extra-pleural and extra-meningeal solitary fibrous tumours: a multi-centre prognostic study. Eur J Surg Oncol. 2016;42(7):1064–70.PubMed
61.
Bahrami A, Lee S, Schaefer IM, Boland JM, Patton KT, Pounds S, Fletcher CD. TERT promoter mutations and prognosis in solitary fibrous tumor. Mod Pathol. 2016;29(12):1511–22.PubMedPubMedCentral
62.
Demicco EG, Wani K, Ingram D, Wagner M, Maki RG, Rizzo A, Meeker A, Lazar AJ, Wang WL. TERT promoter mutations in solitary fibrous tumour. Histopathology. 2018;73(5):843–51.PubMed
Metadata
Title
Thyroid Gland Solitary Fibrous Tumor: Report of 3 Cases and a Comprehensive Review of the Literature
Authors
Lester D. R. Thompson
Christina Wei
Lisa M. Rooper
Sean K. Lau
Publication date
01-12-2019
Publisher
Springer US
Published in
Head and Neck Pathology / Issue 4/2019
Electronic ISSN: 1936-0568
DOI
https://doi.org/10.1007/s12105-019-01012-6

Other articles of this Issue 4/2019

Head and Neck Pathology 4/2019 Go to the issue

Original Paper

Calcifying Epithelial Odontogenic (Pindborg) Tumor in a Child: A Case Report and Literature Review

Original Paper

Secretory Carcinoma of the Thyroid Gland: Report of a Highly Aggressive Case Clinically Mimicking Undifferentiated Carcinoma and Review of the Literature

Sine qua non Clinicopathologic Correlation

Non-cystic Sclerosing Polycystic Adenosis: Diagnosis of a Hitherto Undescribed Pattern

Original Paper

Lichenoid Characteristics in Premalignant Verrucous Lesions and Verrucous Carcinoma of the Oral Cavity

Sine qua non Radiology-Pathology

Histiocytic Necrotizing Lymphadenitis Involving the Neck: Radiology-Pathology Correlation

Case Report

T-Cell/Histiocyte-Rich Large B-Cell Lymphoma: Report of the First Case in the Mandible