creators_name: Gupta, R
creators_name: Gupta, AK
creators_name: Shankar, A
creators_name: Bansal, S
creators_name: Bhattacharya, A
creators_name: Bal, A
creators_id: rijuneeta@yahoo.com
editors_name: Kakkilaya, Srinivas
editors_id: Kakkilaya BS
type: journale
datestamp: 2013-05-04 23:09:27
lastmod: 2013-05-04 23:09:27
metadata_visibility: show
title: Insular Carcinoma of Thyroid Presenting as a Giant Skull Lesion: A Dilemma in Treatment.
ispublished: pub
subjects: OJHAS
full_text_status: public
keywords: Insular carcinoma; Thyroid; Metastasis; Treatment.
abstract: Thyroid surgeons are becoming increasingly more aware of a histologically distinct subset of thyroid carcinoma whose classification falls between well-differentiated and anaplastic carcinomas with respect to both cell differentiation and clinical behavior. This subtype of tumors has been categorized as poorly differentiated or insular carcinoma, based on its characteristic cell groupings. Although the differentiation of insular carcinoma from other thyroid carcinomas has important prognostic and therapeutic significance, relatively little about insular carcinoma has been published in the otolaryngology literature. In this article, we discuss a case of insular carcinoma of thyroid presenting with concurrent distant metastasis to skull, lung, ribs, and inguinal region with review of the literature. We conclude that insular thyroid carcinoma warrants aggressive management with total thyroidectomy and excision of accessible giant lesion followed by radioactive iodine ablation of any remaining thyroid tissue.
date: 2013-01-25
date_type: published
publication: Online Journal of Health and Allied Sciences
volume: 11
number: 4(10)
publisher: Kakkilaya BS
refereed: TRUE
referencetext: 1.	Langhans T. Uber die epithelialen Formen der malignen Struma. Virchows Arch [A] 1907;189:69-188.
2.	Carcangiu ML, Zampi G, Rosai J, et al. Poorly differentiated (“insular”) thyroid carcinoma: a reinterpretation of Langhans’ “wuchernde Struma.” Am J Surg Pathol. 1984;8:655-668.
3.	Pilotti S, Collini P, Mariani L, et al. Insular carcinoma: A distinct de novo entity among follicular carcinomas of the thyroid gland. Am J Surg Pathol 1997;21:1466-1473.
4.	Cometta AJ, Burchard AE, Pribitkin EA et al. Insular carcinoma of the thyroid- original article. Ear, nose & throat Journal. 2003;82(5):384.
5.	Patel KN, Shaha AR. Poorly differentiated and anaplastic thyroid cancer. Cancer Control. 2006;13:119-128.
6.	Ashfaq R, Vuitch F, Delgado R, Albores-Saavedra J. Papillary and follicular thyroid carcinomas with an insular component. Cancer. 1994;73:416-423.
7.	Bhalodia JN, Agnihotri AS, Trivedi NJ et al. Insular carcinoma of thyroid-a gap between well differentiated carcinoma and anaplastic carcinoma of thyroid. Gujarat Journal of Otorhinolaryngology and Head & Neck Surgery.2010;7(1):28-29. Available at http://ent-journal.com/june-july2010.pdf
8.	Justin EP, Seabold JE, Robinson RA et al. Insular carcinoma: a distinct thyroid carcinoma with associated iodine-131 localization. J Nucl Med. 1991;32:1358-1363
9.	Carcangiu ML, Bianchi S. Diffuse sclerosing variant of papillary thyroid carcinoma: clinicopathologic study of 15 cases. Am J Surg Pathol. 1989;13:1041-1049.
citation:   Gupta, R and Gupta, AK and Shankar, A and Bansal, S and Bhattacharya, A and Bal, A  (2013) Insular Carcinoma of Thyroid Presenting as a Giant Skull Lesion: A Dilemma in Treatment.  [Journal (On-line/Unpaginated)]     
document_url: http://cogprints.org/8939/1/2012-4-10.pdf