Malignant thyroid teratoma: an integrated analysis of case series/case reports

in Endocrine-Related Cancer
View More View Less
  • 1 Department of Pathology, Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma, USA
  • 2 Department of Pathology, Cho Ray Hospital, Ho Chi Minh, Vietnam
  • 3 Department of Pathology, University of Medicine and Pharmacy, Ho Chi Minh, Vietnam
  • 4 Department of Pathology and Thyroid Disease Center, Izumi City General Hospital, Izumi-city, Wake-cho, Japan

Correspondence should be addressed to H G Vuong: huyvuong@hotmail.com
Restricted access

Malignant thyroid teratoma (MTT) is a very rare thyroid malignancy. These neoplasms have been reported only in case reports and small-sized case series so far. In this study, we searched for MTTs in the Surveillance, Epidemiology, and End Result (SEER) program during 1975–2016. Subsequently, we incorporated the SEER data with published MTT cases in the literature to analyze the characteristics and prognostic factors of MTTs. Integrated data were analyzed using chi-square or Fisher’s exact test for categorical covariates, and t-test or Mann-Whitney test for continuous variables. We included 28 studies with 36 MTT cases and found additional 8 cases from the SEER program for final analyses. Our results showed that MTT is typically seen in adult females. These neoplasms were associated with an aggressive clinical course with high rates of extrathyroidal extension (80%) and nodal involvement (62%). During follow-up, the development of recurrence and metastases were common (42% and 46%, respectively), and one-third of patients died at the last follow-up. Large tumor size (P  = 0.022) and the presence of metastases during follow-up (P  = 0.008) were associated with a higher mortality rate. In conclusion, our study demonstrated the characteristic features of MTT patients and outlined some parameters associated with a negative outcome which could help clinicians better predict the clinical course of these neoplasms.

 

Society for Endocrinology

Sept 2018 onwards Past Year Past 30 Days
Abstract Views 308 308 241
Full Text Views 14 14 7
PDF Downloads 19 19 11
  • Agaimy A, Witkowski L, Stoehr R, Cuenca JCC, Gonzalez-Muller CA, Brutting A, Bahrle M, Mantsopoulos K, Amin RMS, Hartmann A, et al. 2020 Malignant teratoid tumor of the thyroid gland: an aggressive primitive multiphenotypic malignancy showing organotypical elements and frequent DICER1 alterations-is the term "thyroblastoma" more appropriate? Virchows Archiv 477 787798. (https://doi.org/10.1007/s00428-020-02853-1)

    • Search Google Scholar
    • Export Citation
  • Bale GF 1950 Teratoma of the neck in the region of the thyroid gland; a review of the literature and report of 4 cases. American Journal of Pathology 26 565579.

    • Search Google Scholar
    • Export Citation
  • Baloch ZW, Montone K & Livolsi VA 2011 Images in endocrine pathology: case 1. Endocrine Pathology 22 170171. (https://doi.org/10.1007/s12022-011-9169-4)

    • Search Google Scholar
    • Export Citation
  • Bowker CM & Whittaker RS 1992 Malignant teratoma of the thyroid: case report and literature review of thyroid teratoma in adults. Histopathology 21 8183. (https://doi.org/10.1111/j.1365-2559.1992.tb00350.x)

    • Search Google Scholar
    • Export Citation
  • Buckley NJ, Burch WM & Leight GS 1986 Malignant teratoma in the thyroid gland of an adult: a case report and a review of the literature. Surgery 100 932937.

    • Search Google Scholar
    • Export Citation
  • Buckwalter JA & Layton JM 1954 Malignant teratoma in the thyroid gland of an adult. Annals of Surgery 139 218223. (https://doi.org/10.1097/00000658-195402000-00013)

    • Search Google Scholar
    • Export Citation
  • Chen JS, Lai GM & Hsueh S 1998 Malignant thyroid teratoma of an adult - a long-term survival after chemotherapy. American Journal of Clinical Oncology 21 212214. (https://doi.org/10.1097/00000421-199804000-00025)

    • Search Google Scholar
    • Export Citation
  • Craver RD, Lipscomb JT, Suskind D & Velez MC 2001 Malignant teratoma of the thyroid with primitive neuroepithelial and mesenchymal sarcomatous components. Annals of Diagnostic Pathology 5 285292. (https://doi.org/10.1053/adpa.2001.27918)

    • Search Google Scholar
    • Export Citation
  • Djalilian HR, Linzie B & Maisel RH 2000 Malignant teratoma of the thyroid: review of literature and report of a case. American Journal of Otolaryngology 21 112115. (https://doi.org/10.1016/s0196-0709(0085007-3)

    • Search Google Scholar
    • Export Citation
  • Grewal AK, Wartofsky L, Kumar D & Chia SH 2016 Malignant thyroid teratoma. AACE Clinical Case Reports 2 e284e289. (https://doi.org/10.4158/EP15996.CR)

    • Search Google Scholar
    • Export Citation
  • Hankey BF, Ries LA & Edwards BK 1999 The surveillance, epidemiology, and end results program: a national resource. Cancer Epidemiology, Biomarkers and Prevention 8 11171121.

    • Search Google Scholar
    • Export Citation
  • Isaacs H Jr 1985 Perinatal (congenital and neonatal) neoplasms: a report of 110 cases. Pediatric Pathology 3 165216. (https://doi.org/10.3109/15513818509078782)

    • Search Google Scholar
    • Export Citation
  • Jayaram G, Cheah PL & Yip CH 2000 Malignant teratoma of the thyroid with predominantly neuroepithelial differentiation - fine needle aspiration cytologic, histologic and immunocytochemical features of a case. Acta Cytologica 44 375379. (https://doi.org/10.1159/000328481)

    • Search Google Scholar
    • Export Citation
  • Jordan RB & Gauderer MW 1988 Cervical teratomas: an analysis. Literature review and proposed classification. Journal of Pediatric Surgery 23 583591. (https://doi.org/10.1016/s0022-3468(8880373-7)

    • Search Google Scholar
    • Export Citation
  • Kier R, Silverman PM, Korobkin M, Wain S, Leight G & Burch W Jr 1985 Malignant teratoma of the thyroid in an adult: CT appearance. Journal of Computer Assisted Tomography 9 174176. (https://doi.org/10.1097/00004728-198501000-00030)

    • Search Google Scholar
    • Export Citation
  • Kim E, Bae TS, Kwon Y, Kim TH, Chung KW, Kim SW, Ro J & Lee ES 2007 Primary malignant teratoma with a primitive neuroectodermal tumor component in thyroid gland : a case report. Journal of Korean Medical Science 22 568571. (https://doi.org/10.3346/jkms.2007.22.3.568)

    • Search Google Scholar
    • Export Citation
  • Kimler SC & Muth WF 1978 Primary malignant teratoma of the thyroid: case report and literature review of cervical teratomas in adults. Cancer 42 311317. (https://doi.org/10.1002/1097-0142(197807)42:1<311::aid-cncr2820420147>3.0.co;2-v)

    • Search Google Scholar
    • Export Citation
  • Kingsley DPE, Elton A & Bennett MH 1968 Malignant teratoma of thyroid. Case report and a review of literature. British Journal of Cancer 22 7–11. (https://doi.org/10.1038/bjc.1968.2)

    • Search Google Scholar
    • Export Citation
  • Levey M 1976 An unusual thyroid tumor in a child. Laryngoscope 86 18641868. (https://doi.org/10.1002/lary.5540861212)

  • Majhi U 2009 Primary malignant teratoma of the thyroid in a child with nodal metastases. Indian Journal of Pathology and Microbiology 52 234236. (https://doi.org/10.4103/0377-4929.48929)

    • Search Google Scholar
    • Export Citation
  • Martins T, Carrilho F, Gomes L, Mesquita C, Martins MJ & Carvalheiro M 2006 Malignant teratoma of the thyroid: case report. Thyroid 16 13111313. (https://doi.org/10.1089/thy.2006.16.1311)

    • Search Google Scholar
    • Export Citation
  • Miller DL, Thompson LDR, Bishop JA, Rooper LM & Ali SZ 2020 Malignant teratomas of the thyroid gland: clinico-radiologic and cytomorphologic features of a rare entity. Journal of the American Society of Cytopathology 9 221231. (https://doi.org/10.1016/j.jasc.2020.04.008)

    • Search Google Scholar
    • Export Citation
  • Moher D, Liberati A, Tetzlaff J, Altman DG & PRISMA Group 2009 Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Medicine 6 e1000097. (https://doi.org/10.1371/journal.pmed.1000097)

    • Search Google Scholar
    • Export Citation
  • Murad MH, Sultan S, Haffar S & Bazerbachi F 2018 Methodological quality and synthesis of case series and case reports. BMJ Evidence-Based Medicine 23 6063. (https://doi.org/10.1136/bmjebm-2017-110853)

    • Search Google Scholar
    • Export Citation
  • Murao T, Nakanishi M, Toda K & Konishi H 1979 Malignant teratoma of the thyroid gland in an adolescent female. Acta Pathologica Japonica 29 109117. (https://doi.org/10.1111/j.1440-1827.1979.tb01296.x)

    • Search Google Scholar
    • Export Citation
  • Nissen T & Wynn R 2014 The clinical case report: a review of its merits and limitations. BMC Research Notes 7 264. (https://doi.org/10.1186/1756-0500-7-264)

    • Search Google Scholar
    • Export Citation
  • Nose V 2020 DICER1 gene alterations in thyroid diseases. Cancer Cytopathology 128 688689. (https://doi.org/10.1002/cncy.22327)

  • Ogawa K, Toita T, Nakamura K, Uno T, Onishi H, Itami J, Shikama N, Saeki N, Yoshii Y & Murayama S 2003 Treatment and prognosis of patients with intracranial nongerminomatous malignant germ cell tumors: a multiinstitutional retrospective analysis of 41 patients. Cancer 98 369376. (https://doi.org/10.1002/cncr.11495)

    • Search Google Scholar
    • Export Citation
  • Perez-Mies B, Zapata RMR, Garcia-Fernandez E & Serrano MN 2010 Malignant teratoma of the thyroid in a pregnant woman. Annals of Diagnostic Pathology 14 264267. (https://doi.org/10.1016/j.anndiagpath.2009.07.004)

    • Search Google Scholar
    • Export Citation
  • Pichler R, Heidegger I, Brunner A & Steiner H 2014 Long-term follow-up of a primary teratoma with somatic-type malignancy within the thyroid gland mimicking thyroid carcinoma. Clinical Genitourinary Cancer 12 e221e224. (https://doi.org/10.1016/j.clgc.2014.03.014)

    • Search Google Scholar
    • Export Citation
  • Prat J, Nogales FF, Cao D, Vang R, Carinelli SG & Zaloudek CJ 2014 Germ cell tumors. In WHO Classification of Tumors of Female Reproductive Organs, pp 5768. Eds. Kurman RJ, Carcangiu ML, Herrington CS, Young RHLyon: World Health Organization.

    • Search Google Scholar
    • Export Citation
  • Rabinowits G, Barletta J, Sholl LM, Reche E, Lorch J & Goguen L 2017 Successful management of a patient with malignant thyroid teratoma. Thyroid 27 125128. (https://doi.org/10.1089/thy.2016.0201)

    • Search Google Scholar
    • Export Citation
  • Ramadas K, Augustin J, Parameswaran S & Joseph F 1996 Case report: malignant teratoma in the thyroid gland. British Journal of Radiology 69 879880. (https://doi.org/10.1259/0007-1285-69-825-879)

    • Search Google Scholar
    • Export Citation
  • Ramsey T, Curran K, Mouzakes J, Gildener-Leapman N & Galati L 2021 A SEER database study of malignant teratomas in the head and neck region. International Journal of Pediatric Otorhinolaryngology 144 110672. (https://doi.org/10.1016/j.ijporl.2021.110672)

    • Search Google Scholar
    • Export Citation
  • Rooper LM, Bynum JP, Miller KP, Lin MT, Gagan J, Thompson LDR & Bishop JA 2020 Recurrent DICER1 hotspot mutations in malignant thyroid gland teratomas molecular characterization and proposal for a separate classification. American Journal of Surgical Pathology 44 826833. (https://doi.org/10.1097/PAS.0000000000001430)

    • Search Google Scholar
    • Export Citation
  • Schmoll HJ, Souchon R, Krege S, Albers P, Beyer J, Kollmannsberger C, Fossa SD, Skakkebaek NE, de Wit R, Fizazi K, et al. 2004 European consensus on diagnosis and treatment of germ cell cancer: a report of the european germ cell cancer consensus group (EGCCCG). Annals of Oncology 15 13771399. (https://doi.org/10.1093/annonc/mdh301)

    • Search Google Scholar
    • Export Citation
  • Smirniotopoulos JG & Chiechi MV 1995 Teratomas, dermoids, and epidermoids of the head and neck. RadioGraphics 15 14371455. (https://doi.org/10.1148/radiographics.15.6.8577967)

    • Search Google Scholar
    • Export Citation
  • Starling CE, Sabra J, Brady B, Horton M & Traweek ST 2019 Malignant teratoma of the thyroid: a difficult diagnosis by fine-needle aspiration. Diagnostic Cytopathology 47 930934. (https://doi.org/10.1002/dc.24216)

    • Search Google Scholar
    • Export Citation
  • Thompson LD, Rosai J & Heffess CS 2000 Primary thyroid teratomas: a clinicopathologic study of 30 cases. Cancer 88 11491158. (https://doi.org/10.1002/(SICI)1097-0142(20000301)88:5<1149::AID-CNCR27>3.0.CO;2-V)

    • Search Google Scholar
    • Export Citation
  • Ting J, Bell D, Ahmed S, Ying A, Waguespack SG, Tu SM, Weber R & Zafereo M 2019 Primary malignant thyroid teratoma: an institutional experience. Thyroid 29 229236. (https://doi.org/10.1089/thy.2018.0206)

    • Search Google Scholar
    • Export Citation
  • Tsang RW, Brierley JD, Asa SL & Sturgeon JF 2003 Malignant teratoma of the thyroid: aggressive chemoradiation therapy is required after surgery. Thyroid 13 401404. (https://doi.org/10.1089/105072503321669901)

    • Search Google Scholar
    • Export Citation
  • Ueno NT, Amato RJ, Ro JJ & Weber RS 1998 Primary malignant teratoma of the thyroid gland: report and discussion of two cases. Head and Neck 20 649653. (https://doi.org/10.1002/(sici)1097-0347(199810)20:7<649::aid-hed13>3.0.co;2-5)

    • Search Google Scholar
    • Export Citation
  • Vilallonga R, Zafon C, Ruiz-Marcellan C, Obiols G, Fort JM, Baena JA, Villanueva B, Garcia A & Sobrinho-Simões M 2013 Malignant thyroid teratoma: report of an aggressive tumor in a 64-year-old man. Endocrine Pathology 24 132135. (https://doi.org/10.1007/s12022-013-9250-2).

    • Search Google Scholar
    • Export Citation
  • Villacrés Montesdeoca L, Villacrés F & Muñoz R 2018 Malignant thyroid teratoma with neuroectodermal component: a case report. International Journal of Cancer Studies & Research 7 137138.(https://doi.org/10.19070/2167-9118-1800025)

    • Search Google Scholar
    • Export Citation
  • Wang J, Bi N, Wang X, Hui Z, Liang J, Lv J, Zhou Z, Feng QF, Xiao Z, Chen D, et al. 2015 Role of radiotherapy in treating patients with primary malignant mediastinal non-seminomatous germ cell tumor: a 21-year experience at a single institution. Thoracic Cancer 6 399406. (https://doi.org/10.1111/1759-7714.12190)

    • Search Google Scholar
    • Export Citation