![]() All the patients in our series presented with cervical mass without increase of sCT and CEA. When the tumor causes compression or invasion to the surrounding tissues, the corresponding clinical symptoms may appear, and lymph node metastasis is easy to occur in the early stage. In addition, serum calcitonin (sCT) is the most sensitive and specific marker for preoperative diagnosis of MTC, and serum CEA is synchronous with sCT in some MTC patients, which is of reference value for diagnosis and prognosis of the disease. MTC patients generally have no specific clinical symptoms, only presenting with a painless thyroid mass, sometimes presenting with intractable diarrhea, facial flushing or other neuroendocrine symptoms. The clinical symptoms of spindle cell variant MTC are consistent with MTC. MTC is a neuroendocrine tumor, accounting for 5% ~ 10% of thyroid malignant tumors. We reviewed 99 cases of MTC confirmed in our hospital from 2012 to 2019, only 4 cases spindle cell variant MTC meet the criteria, accounting for 4% of all MTC. Spindle cell variant MTC is a rare type of MTC, and only 5 cases have been reported in literatures thus far. Appropriate positive and negative controls were run in parallel. Unless otherwise stated, all antibodies were mouse monoclonal and from DAKO Corporation (Dako North America, Inc., Carpinteria, CA, USA). Immunohistochemical staining was performed using Dako EnVision Peroxidase detection system on Roche Ventana Benchmark XT autostainer (Ventana Medical Systems, Tucson, AZ). Tissue sections of 4 ~ 5 μm thickness were prepared and stained with hematoxylin and eosin (H&E), and additional sections were stained with Congo red. The tissue samples were fixed with 10% neutral formalin and embedded in paraffin. Two cases occurred in the left lobe of thyroid, and another 2 cases occurred in the right lobe of thyroid, including 1 case with gravelly calcification and 1 case with ipsilateral lymph node metastasis. Ultrasound showed solid and hypoechoic nodules of 2 ~ 6 cm in diameter. Thyroid function test was within normal range. Biochemical examination showed normal serum parathormone level. On clinical examination, mass was diffuse and firm, moving with deglutition. Patients visited hospital with the accidental discovery of painless neck mass accompanied by gradual enlargement. Due to its rarity and special morphology, the diagnosis of spindle cell variant MTC relies on its morphology and immunohistochemical markers to avoid misdiagnosis.įour cases of spindle cell variant MTC were collected from 2012 to 2019, including 2 males and 2 females, aged 26 to 54 years old. We report 4 rare cases of spindle cell variant of MTC. Immunohistochemistry showed that the tumor cells were positive for calcitonin, chromogranin A, synaptophysin, CD56, and TTF-1, but negative for other lineage-specific markers. Histologically, the tumors showed spindle shaped cells in bundles or interlaced arrangement, separated by hyalinised fibrous stroma that contained amyloid deposits. Three patients underwent total thyroidectomy and regional lymph node dissection, and 1 patient underwent thyroid mass resection. Ultrasound showed solid and hypoechoic nodules. Here we describe 4 cases of spindle cell variant of MTC collected from 2012 to 2019. Among them, spindle cell variant is extremely rare. ![]() More than 14 histological variants have been described. It accounts for about 10% of all thyroid malignancies. Medullary thyroid carcinoma (MTC) is a malignant tumor derived from C cells. ![]()
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