The ‘CASTLE’ tumour: An extremely rare presentation of a thyroid malignancy. A case report

Publication date: Available online 30 June 2019Source: Annals of Medicine and SurgeryAuthor(s): Diana Mellisa Dualim, Loo Guo Hou, Shahrun Niza Abdullah Suhaimi, Nani Harlina Md Latar, Rohaizak Muhammad, Nordashima Abd ShukorAbstractThyroid carcinoma showing thymic-like differentiation (CASTLE) is a rare malignancy of the thyroid gland, and it accounts for 0.1–0.15 % of all thyroid cancers. As the name suggests, it has a histological and immunophenotypic resemblance to thymic carcinoma. Preoperative diagnosis of CASTLE can be difficult as its clinical manifestations, and histological characteristic resembles other aggressive and advanced thyroid carcinomas. It is essential to distinguish CASTLE from other aggressive neoplasms as the former has a more favourable prognosis. Immunohistochemical staining with CD5 can help to differentiate thyroid CASTLE from other aggressive thyroid neoplasms.Due to the rarity of this disease, there is no clear definitive treatment strategy. Surgical resection of CASTLE is usually attempted initially. Nodal involvement and extrathyroidal extension are shown to be the main prognostic factors that influenced the survival of patients. Therefore, complete resection of the tumour is vital to reduce local recurrence rates and to improve the chance of long-term survival. Radiotherapy (RT) for CASTLE is an effective treatment. Curative surgery followed by adjuvant RT should be considered in cases with extrathyroidal extension and nodal metastases. ...
Source: Annals of Medicine and Surgery - Category: General Medicine Source Type: research

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Condition:   Thyroid Cancer Intervention:   Drug: dabrafenib and trametinib Sponsors:   National University Hospital, Singapore;   Singapore General Hospital Not yet recruiting
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