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Postoperative spindle cell nodule after thyroidectomy: A case mimicking recurrence with anaplastic transformation of thyroid cancer

Authors

  • Sun Wook Kim MD, PhD,

    1. Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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  • Young Lyun Oh MD, PhD,

    1. Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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  • Joon Young Choi MD, PhD,

    1. Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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  • Ji In Lee MD,

    1. Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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  • Jae Hoon Chung MD, PhD,

    1. Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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  • Jee Soo Kim MD, PhD

    Corresponding author
    1. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
    • Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Abstract

Background

Here, we report a case of a postoperative spindle cell nodule that mimicked recurrence with anaplastic transformation after thyroidectomy.

Methods

The course of the disease is described. The mass was studied morphologically and immunohistochemically.

Results

A 31-year-old woman underwent total thyroidectomy for papillary thyroid carcinoma. A mass suspected of recurrence was found 14 months later and caused dysphagia and dyspnea. An 18F-fluorodeoxyglucose positron emission tomographic (18F-FDG-PET) scan showed a lesion with high uptake; however, a fine-needle aspiration biopsy (FNAB) was inconsistent with recurrent cancer. The mass was resected and was composed of elongated spindle cells, with eosinophilic cytoplasm within a myxoid background. Immunohistochemical staining was strongly positive for vimentin, focally positive for smooth muscle actin, desmin, and p53, and negative for cytokeratin AE1/AE3, Cam5.2, epithelial membrane antigen (EMA), and anaplastic lymphoma kinase (ALK-1).

Conclusion

Although postoperative spindle cell nodules are rare after thyroid surgery, it should be considered in the differential diagnosis for recurrent masses at the operative site. Head Neck, 2013

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