Regressed Papillary Thyroid Carcinoma with Anaplastic Transformation into Lymph Node Metastasis: Case Report with Review of the Literature

<b>Background</b>: Small papillary thyroid carcinomas with the largest dimension of 10 mm are slow-growing and self-limiting tumors, most of which have no potential for progression, rarely becoming clinically evident carcinomas or undergoing regressive changes. Their anaplastic transform...

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Main Authors: Bozidar Kovacevic, Bojana Rancic, Sasa Jovic, Snezana Cerovic, Vesna Skuletic, Jelena Karajovic, Milka Gardasevic, Gordana Supic, Kennichi Kakudo
Format: Article
Language:English
Published: MDPI AG 2025-02-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/5/523
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author Bozidar Kovacevic
Bojana Rancic
Sasa Jovic
Snezana Cerovic
Vesna Skuletic
Jelena Karajovic
Milka Gardasevic
Gordana Supic
Kennichi Kakudo
author_facet Bozidar Kovacevic
Bojana Rancic
Sasa Jovic
Snezana Cerovic
Vesna Skuletic
Jelena Karajovic
Milka Gardasevic
Gordana Supic
Kennichi Kakudo
author_sort Bozidar Kovacevic
collection DOAJ
description <b>Background</b>: Small papillary thyroid carcinomas with the largest dimension of 10 mm are slow-growing and self-limiting tumors, most of which have no potential for progression, rarely becoming clinically evident carcinomas or undergoing regressive changes. Their anaplastic transformation, primarily in the thyroid gland or into lymph node metastasis, is extremely rare. <b>Case Presentation</b>: A 66-year-old female patient was admitted to our hospital for diagnostics and treatment of a large tumor on the left neck side. Preoperative imaging and cytological findings of the neck tumor suggested metastasis of papillary thyroid carcinoma. Total thyroidectomy and metastasectomy were performed. In the final diagnosis, anaplastic transformation of the papillary thyroid carcinoma’s metastasis in the neck was confirmed. Opposite to advanced dedifferentiation of metastasis, primary tumor foci in the thyroid were regressed and replaced with sclerosis and microcalcification. The synchronous co-occurrence of incidental primary thyroid carcinoma and anaplastic thyroid carcinoma originating from ectopic cervical thyroid tissue was considered diagnostically. <b>Conclusions</b>: The case highlights the necessity of regular monitoring of the thyroid and neck lymph nodes for patients under active surveillance, including those with small calcified tumor foci. This paper also comprehensively reviews the existing literature on this topic.
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spelling doaj-art-b12735bf7c374a0fbb3a90e8f3bcdc3c2025-08-20T02:05:17ZengMDPI AGDiagnostics2075-44182025-02-0115552310.3390/diagnostics15050523Regressed Papillary Thyroid Carcinoma with Anaplastic Transformation into Lymph Node Metastasis: Case Report with Review of the LiteratureBozidar Kovacevic0Bojana Rancic1Sasa Jovic2Snezana Cerovic3Vesna Skuletic4Jelena Karajovic5Milka Gardasevic6Gordana Supic7Kennichi Kakudo8Institute of Pathology and Forensic Medicine, Military Medical Academy, 11000 Belgrade, SerbiaInstitute of Pathology and Forensic Medicine, Military Medical Academy, 11000 Belgrade, SerbiaMedical Faculty of the Military Medical Academy, University of Defense, 11000 Belgrade, SerbiaInstitute of Pathology and Forensic Medicine, Military Medical Academy, 11000 Belgrade, SerbiaInstitute of Pathology and Forensic Medicine, Military Medical Academy, 11000 Belgrade, SerbiaClinic of Endocrinology, Military Medical Academy, 11000 Belgrade, SerbiaClinic of Maxillofacial Surgery, Military Medical Academy, 11000 Belgrade, SerbiaMedical Faculty of the Military Medical Academy, University of Defense, 11000 Belgrade, SerbiaDepartment of Pathology, Wakayama University Medical School, Wakayama 641-0096, Japan<b>Background</b>: Small papillary thyroid carcinomas with the largest dimension of 10 mm are slow-growing and self-limiting tumors, most of which have no potential for progression, rarely becoming clinically evident carcinomas or undergoing regressive changes. Their anaplastic transformation, primarily in the thyroid gland or into lymph node metastasis, is extremely rare. <b>Case Presentation</b>: A 66-year-old female patient was admitted to our hospital for diagnostics and treatment of a large tumor on the left neck side. Preoperative imaging and cytological findings of the neck tumor suggested metastasis of papillary thyroid carcinoma. Total thyroidectomy and metastasectomy were performed. In the final diagnosis, anaplastic transformation of the papillary thyroid carcinoma’s metastasis in the neck was confirmed. Opposite to advanced dedifferentiation of metastasis, primary tumor foci in the thyroid were regressed and replaced with sclerosis and microcalcification. The synchronous co-occurrence of incidental primary thyroid carcinoma and anaplastic thyroid carcinoma originating from ectopic cervical thyroid tissue was considered diagnostically. <b>Conclusions</b>: The case highlights the necessity of regular monitoring of the thyroid and neck lymph nodes for patients under active surveillance, including those with small calcified tumor foci. This paper also comprehensively reviews the existing literature on this topic.https://www.mdpi.com/2075-4418/15/5/523spontaneous tumor regressionpapillary thyroid carcinomaanaplastic transformationanaplastic thyroid carcinoma
spellingShingle Bozidar Kovacevic
Bojana Rancic
Sasa Jovic
Snezana Cerovic
Vesna Skuletic
Jelena Karajovic
Milka Gardasevic
Gordana Supic
Kennichi Kakudo
Regressed Papillary Thyroid Carcinoma with Anaplastic Transformation into Lymph Node Metastasis: Case Report with Review of the Literature
Diagnostics
spontaneous tumor regression
papillary thyroid carcinoma
anaplastic transformation
anaplastic thyroid carcinoma
title Regressed Papillary Thyroid Carcinoma with Anaplastic Transformation into Lymph Node Metastasis: Case Report with Review of the Literature
title_full Regressed Papillary Thyroid Carcinoma with Anaplastic Transformation into Lymph Node Metastasis: Case Report with Review of the Literature
title_fullStr Regressed Papillary Thyroid Carcinoma with Anaplastic Transformation into Lymph Node Metastasis: Case Report with Review of the Literature
title_full_unstemmed Regressed Papillary Thyroid Carcinoma with Anaplastic Transformation into Lymph Node Metastasis: Case Report with Review of the Literature
title_short Regressed Papillary Thyroid Carcinoma with Anaplastic Transformation into Lymph Node Metastasis: Case Report with Review of the Literature
title_sort regressed papillary thyroid carcinoma with anaplastic transformation into lymph node metastasis case report with review of the literature
topic spontaneous tumor regression
papillary thyroid carcinoma
anaplastic transformation
anaplastic thyroid carcinoma
url https://www.mdpi.com/2075-4418/15/5/523
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